2012 Annual Consumer Survey Report December 2012 Office of Information Management Arizona Department of Health Services Division of Behavioral Health Services Bureau of Quality Management Operations 2012 Consumer Survey Report TABLE OF CONTENTS EXECUTIVE SUMMARY…………………………………………………..………………………….4 INTRODUCTION……………………………………………………………...............................6 SURVEY SAMPLE AND RESPONSE RATES...……………………………………….………6 METHODOLOGY AND SURVEY ADMINISTRATION………………….…………………...7 DATA ANALYSIS………………….…………………………………………………….………8 STATEWIDE SURVEY DATA LIMITATIONS………………………………………………...9 ADULT SURVEY ANALYSIS AND RESULTS..........................................................................9 RBHA SPECIFIC ADULT INITIATIVES……………………………………………………...14 YSS-F SURVEY ANALYSIS AND RESULTS...………………………………………………15 RBHA SPECIFIC YSS-F INITIATIVES………………………………………………....……..20 STATEWIDE IMPROVEMENT OPPORTUNITIES…………………………………………..21 ADHS/DBHS INITIATIVES…………………………………………………….……...............21 CONCLUSION……………………………………………………………………….……...…..24 ATTACHMENTS Attachment A: 2012 Tribal Behavioral Health Authority Health Survey Results Attachment B: 2012 Statewide Consumer Survey Protocol Attachment C: 2012 Raw Data Attachment D: 2012 Adult Demographics Attachment E: 2012 Adult Line Item Attachment F: 2012 YSS-F Demographics Attachment G: 2012 YSS-F Line Item Attachment H: List of Acronyms 2 2012 Consumer Survey Report APPENDICES YEAR 2012 ADULT CONSUMER SURVEY (ENGLISH AND SPANISH) YEAR 2012 YOUTH CONSUMER SURVEY FOR FAMILIES (ENGLISH AND SPANISH) 3 2012 Consumer Survey Report I. Executive Summary The Arizona Department of Health Services/Division of Behavioral Health Services (ADHS/DBHS), Tribal/Regional Behavioral Health Authorities (T/RBHAs) and contracted service providers jointly conduct statewide consumer surveys during each fiscal year. Each year, two surveys are administered based on the Substance Abuse and Mental Health Services Administration‟s (SAMSHA‟s) Mental Health Statistics Improvement Program (MHSIP) consumer surveys: The Adult Consumer Survey and The Youth Services Survey for Families (YSS-F). The surveys request independent feedback from Title XIX/XXI adults and families of youth receiving services through Arizona‟s publicly funded behavioral health system. The surveys measure consumers‟ perceptions of behavioral health services in relation to the following domains: General Satisfaction Access to Services Service Quality/Appropriateness Participation in Treatment Outcomes Cultural Sensitivity Improved Functioning Social Connectedness Within ADHS/DBHS, Consumer Survey results are:  Reviewed by the ADHS/DBHS Quality Management (QM) Committee;  Used by the QM Committee as a critical information source to drive system improvements through RBHA contracts and QM Plans;  Incorporated into the Annual Performance Improvement Reports to provide a comprehensive update on performance across contractual performance measures; and  Used for certain Performance Incentive System calculations. Survey outcomes are also:  Disseminated to ADHS/DBHS stakeholders and consumers via the ADHS/DBHS website and Performance Dashboard;  Submitted to these national organizations as part of federal grant requirements for use in national reporting and evaluation: o The National Association of State Mental Health Program Directors‟ (NASMHPD) o National Research Institute (NRI) o Western States Decision Support Group (WSDSG) o Substance Abuse and Mental Health Services Administration‟s (SAMHSA) Mental Health Statistics Improvement Program (MHSIP) 4 2012 Consumer Survey Report The fiscal year 2012 survey was conducted from April through May 2012. Adult and Youth survey results are summarized as follows. Adult Consumer Survey results: Statewide: Participation in Treatment Planning domain showed a statistically significant increase from 2011. Outcomes domain scores improved by two percentage points. General Satisfaction, Service Access, and Service Quality & Appropriateness domain scores each decreased by one percentage point. Improved Functioning and Social Connectedness domains showed no changes from the 2011 survey results. RBHA Specific: Magellan (GSA 6) showed a statistically significant increase of seven percentage points in the Participation in Treatment Planning domain compared to 2011. Cenpatico in GSA 2 showed statistically significant decreases in two domains: Outcomes by thirteen percentage points and Improved Functioning by seven percentage points. CPSA (GSA 5) had statistically significant decreases in two domains: Service Access by seven percentage points and Service Quality & Appropriateness by six percentage points. YSS-F Consumer Survey results: Statewide: Participation in Treatment Planning, Outcomes and Social Connectedness domains showed statistically significant decreases from 2011. Improved Functioning domain increased by one percentage point. General Satisfaction, Service Access, and Cultural Sensitivity domains demonstrated no increases or decreases from 2011. RBHA Specific: Cenpatico in GSA 3 demonstrated a statistically significant increase of seven percentage points in the Participation in Treatment Planning domain from 2011. CPSA (GSA 5) experienced statistically significant decreases in Cultural Sensitivity and Outcomes domains by six percentage points. Regional Behavioral Health Authorities (RBHA) and Tribal Behavioral Health Authorities (TBHA) results from the 2012 Consumer Survey are presented separately to preserve the integrity of findings as two different sampling methodologies were used to get the survey sample. Refer to Section III-Survey Response Rates for details about the differences in the RBHA and TBHA surveys. 5 2012 Consumer Survey Report II. Introduction The Arizona Department of Health Services/Division of Behavioral Health Services (ADHS/DBHS) and the Regional Behavioral Health Authorities (RBHAs) in collaboration with their contracted providers administered the statewide consumer survey during April and May of 2012. Within ADHS/DBHS, Consumer Survey results are:  Reviewed by the ADHS/DBHS Quality Management (QM) Committee;  Used by the QM Committee as a critical information source to drive system improvements through RBHA contracts and QM Plans;  Incorporated into the Annual Performance Improvement Reports to provide a comprehensive update on performance across contractual performance measures; and  Used for certain Performance Incentive System calculations. Survey outcomes are also:  Disseminated to ADHS/DBHS stakeholders and consumers via the ADHS/DBHS website and Performance Dashboard;  Submitted to these national organizations as part of federal grant requirements for use in national reporting and evaluation: o The National Association of State Mental Health Program Directors‟ (NASMHPD) o National Research Institute (NRI) o Western States Decision Support Group (WSDSG) o Substance Abuse and Mental Health Services Administration‟s (SAMHSA) Mental Health Statistics Improvement Program (MHSIP) III. Survey Sample and the Response Rates A total of 6,960 RBHA-enrolled consumers were included for the MHSIP Consumer Survey random sample pool; 3,958 consumers were contacted and asked to complete a survey. The response rate is calculated by dividing the number of surveys returned by the number of enrollees asked to participate. Statewide response rates based on surveys offered were 86% for adults and 85% for youth, as seen in TABLE-1. Please see Attachment B for a complete discussion of the survey protocol. The Tribal Behavioral Health Authorities (TBHA) scores are not included in the statewide results due to the TBHA convenience sampling methodology which solicits responses at the convenience of the recipients rather than from a random sample of TBHA enrolled recipients. Therefore the results are reported separately in Attachment A-2012 Tribal Behavioral Health Authority Health Survey Results. 6 2012 Consumer Survey Report TABLE-1: Survey Response Rate Based on Surveys Offered for Each RBHA/GSA Consumer Survey 2012 Surveys Offered (a) RBHA/GSA GSA 1 - NARBHA GSA 2 - Cenpatico GSA 3 - Cenpatico GSA 4 - Cenpatico GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Overall 757 573 650 656 701 621 3,958 Adult 370 351 364 314 387 338 2,124 Youth 387 222 286 342 314 283 1,834 Surveys Completed (b) Overall 735 436 544 578 512 575 3,380 Adult 354 290 303 275 308 295 1,825 Youth 381 146 241 303 204 280 1,555 Response Rate (b/a) Overall 97% 76% 84% 88% 73% 93% 85% Adult 96% 83% 83% 88% 80% 87% 86% Youth 98% 66% 84% 89% 65% 99% 85% IV. Methodology and Survey Administration Two survey populations (sampling frame) were identified for use in the Adult Consumer Survey and the YSS-F: Adults - Title XIX/XXI behavioral health recipients who are 18 years of age or older, and are enrolled in any of the adult programs: Serious Mental Illness (SMI), Substance Abuse or General Mental Health (Non-SMI). Youth - Title XIX/XXI behavioral health recipients under age 18 and enrolled in the Child/Adolescent program. A total of 58,632 adult and 33,157 youth RBHA-enrolled Title XIX/XXI consumers were eligible to participate in the 2012 survey. Please refer to Attachment B (2012 Consumer Survey Protocol) for details on sampling frame development, inclusion/exclusion criteria, survey instruments, and survey administration guidelines. The ADHS/DBHS Consumer Survey utilized a Likert Scale model to have respondents rate the domain questions from strongly agree (numeric value of 5) to strongly disagree (numeric value of 1), and an option for Not Applicable (numeric value 0). Consumer perception was determined as positive for those domains where the question responses equaled 3.5 or above. TABLE-2 and TABLE-3 show the number and percentage of sample surveys that were not included in the domain score, presented by RBHA/GSA and domain. Surveys are excluded from a domain‟s score when more than one-third of the questions have a response that cannot be determined. This occurs most often when no response is marked, and can also occur if more than one response is marked. See Attachment B for a full discussion of the survey protocol. 7 2012 Consumer Survey Report TABLE-2: Adult Number and Percent of Surveys Excluded Due to Non-Responses by Domain and RBHA /GSA RBHA General Satisfaction Service Access Participation in Treatment Planning Service Quality & Appropriateness Outcomes Improved Functioning Social Connectedness GSA 1 - NARBHA GSA 2 - Cenpatico GSA 3 - Cenpatico GSA 4 - Cenpatico GSA 5 - CPSA GSA 6 - Magellan 7 (2.0%) 2 (0.7%) 2 (0.7%) 2 (0.7%) 3 (1.0%) 7 (2.4%) 7 (2.0%) 3 (1.0%) 4 (1.3%) 1 (0.4%) 6 (2.0%) 12 (4.1%) 14 (4.0%) 6 (2.1%) 22 (7.3%) 8 (2.9%) 21 (6.8%) 28 (9.5%) 6 (1.7%) 3 (1.0%) 12 (4.0%) 9 (3.3%) 10 (3.3%) 17 (5.8%) 16 (4.5%) 9 (3.1%) 21 (6.9%) 8 (2.9%) 16 (5.2%) 17 (5.8%) 15 (4.2%) 5 (1.7%) 12 (4.0%) 10 (3.6%) 16 (5.2%) 26 (8.8%) 16 (4.5%) 10 (3.4%) 15 (5.0%) 9 (3.3%) 15 (4.9%) 18 (6.1%) Statewide RBHA 23 (1.3%) 33 (1.8%) 99 (5.4%) 87 (4.8%) 84 (4.6%) 83 (4.6%) 57 (3.1%) TABLE-3: Youth Number and Percent of Surveys Excluded Due to Non-Responses by Domain and RBHA/GSA RBHA General Satisfaction Service Access Participation in Treatment Planning Cultural Sensitivity Outcomes Improved Functioning Social Connectedness GSA 1 - NARBHA GSA 2 - Cenpatico GSA 3 – Cenpatico GSA 4 – Cenpatico GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA 2 (0.5%) 0 3 (1.3%) 6 (2.0%) 3 (1.5%) 8 (2.9%) 22 (1.4%) 9 (2.4%) 3 (2.1%) 5 (2.1%) 5 (1.7%) 10 (4.9%) 14 (5.1%) 46 (3.0%) 3 (0.8%) 1 (0.7%) 3 (1.3%) 8 (2.7%) 7 (3.4%) 8 (2.9%) 30 (2.0%) 16 (4.3%) 2 (1.4%) 8 (3.3%) 10 (3.3%) 22 (10.8%) 22 (8.0%) 80 (5.2%) 6 (1.6%) 1 (0.7%) 3 (1.3%) 5 (1.7%) 4 (2.0%) 6 (2.2%) 25 (1.6%) 4 (1.1%) 1 (0.7%) 3 (1.3%) 5 (1.7%) 4 (2.0%) 4 (1.5%) 21 (1.4%) 6 (1.6%) 2 (1.4%) 5 (2.1%) 8 (2.7%) 6 (2.9%) 15 (5.5%) 42 (2.7%) V. Data Analysis ADHS/DBHS provided each RBHA with an Access database to compile survey responses. All completed surveys were entered and the database was submitted to ADHS/DBHS. Each RBHA analyzed its respective survey data using an SPSS script designed and provided by ADHS/DBHS to ensure consistency in data analysis. Statewide survey data is analyzed as follows: By Domain; By Domain Line Item; Sub-group Analysis; and Comparison to Past Survey Performance. The statewide survey results are weighted to correct the sample design, taking the different population sizes for each Geographic Service Area (GSA) into consideration. The weighted averages were taken to avoid the over/under representation of highly/less populated GSAs. Please refer to Attachment C, 2012 Raw Data, for further specifics of the weighting methodology and weights applied to each GSA. 8 2012 Consumer Survey Report VI. Statewide Survey Data Limitations Two different sampling methodologies were used to get the 2012 Consumer Survey sample. The Tribal Behavioral Health Authorities (TBHA) scores could not be included in the statewide results due to the TBHA convenience sampling methodology which solicits responses at the convenience of the recipients and providers rather than from a random sample of TBHA enrolled recipients. VII. Adult Survey Analysis and Results Demographics A total of 1,825 completed adult surveys were analyzed. The breakout of the respondents is by gender, age, ethnicity, race, length of enrollment in services, length of enrollment and behavioral health category. Please see Attachment D, 2012 Adult Demographics for complete demographics information. Domain Line Item Analysis A specific set of questions was developed to gather scores for each domain. Line items are specific questions pertaining to each survey domain (Attachment E, 2012 Adult Line Item); analysis of the respondents‟ answers to a question under a domain, either positive or negative, affects the overall domain score. Table-4 demonstrates the results of the 2012 Adult Survey and compares them to previous surveys. The t-test analysis was used to compare 2011 and 2012 to determine if there were any statistically significant differences between each domain‟s average scores. A P-value of 95% significance when less than or equal to 0.05 or “ns” for “not significant” is listed to reflect the change from the prior year. The statewide statistics are based on weighted scores. TABLE-4 Statewide RBHA Adult Consumer Survey Results by Domain for 2007 – 2012 Domain General Satisfaction Service Access Participation in Treatment Planning Service Quality & Appropriateness Outcomes Improved Functioning Social Connectedness Color Key statistically significant increase statistically significant decrease 9 2007 % 86 77 79 88 74 66 65 2008 % (P-value) 82 (ns) 73 (ns) 89 (0.01) 84 (ns) 68 (ns) 68 (ns) 68 (ns) 2009 % (P-value) 84 (ns) 78 (ns) 82 (0.03) 89 (ns) 70 (ns) 68 (ns) 68 (ns) 2010 % (P-value) 86 (ns) 81 (ns) 92 (0.01) 90 (ns) 75 (ns) 71 (ns) 79 (0.02) 2011 % (P-value) 86 (ns) 84 (ns) 87 (ns) 88 (ns) 72 (ns) 69 (ns) 76 (ns) 2012 % (P-value) 85 (ns) 83 (ns) 90 (0.01) 87 (ns) 74 ns) 69 (ns) 76 (ns) 2012 Consumer Survey Report The 2012 Statewide Adult Survey Results: General Satisfaction: Three questions were asked in the survey to ascertain General Satisfaction (Attachment E). The overall score for this domain is 85%, representing an average score based on three questions. This domain decreased by one percentage point compared to the 2011 survey results. However this decrease is not statistically significant. Service Access: Six questions in the survey gathered information regarding Access to Services (Attachment E). The average score for this domain is 83%, representing a one percentage point decrease from 2011. However this decrease is not statistically significant. Participation in Treatment Planning: Two survey questions are used to ascertain score for the Participation in Treatment Planning (Attachment E). The average score for this domain is 90%. This domain increased by three percentage points demonstrating a statistically significant increase in comparison to the 2011 results. Service Quality and Appropriateness: Nine questions in the survey focused on Service Quality and Appropriateness (Attachment E). The average score for this domain is 87%. This domain declined by one percentage point. However this decline is not statistically significant. Outcomes: Eight questions were asked to get consumers‟ perception on Outcomes (Attachment E). The overall score for this domain is 74%. This score increased by two percentage points from 2011, however the increase is not statistically significant. Improved Functioning: Five questions indicate respondents‟ impressions of Improved Functioning (Attachment E). The overall score for this domain is 69%. No increases or decreases were found in this domain. Social Connectedness: Four questions were asked in the survey to ascertain Social Connectedness (Attachment E). This domain scored 76%. There were no increases or decreases in comparison to the 2011 results. RBHA and GSA specific Adult survey findings are presented in tables 5 through 10 (page 11 and 12); the Tables include percentages and P-values for each domain by RBHA and GSA ranging from 2007 through 2012. 10 2012 Consumer Survey Report TABLE-5: GSA 1 - NARBHA Adult Consumer Survey Results by Domain for 2007 - 2012 Domain General Satisfaction Service Access Participation in Treatment Planning Service Quality & Appropriateness Outcomes Improved Functioning Social Connectedness 2007 % 84 73 78 87 74 63 61 2008 % (P-value) 85 (ns) 80 (ns) 92 (0.00) 88 (ns) 71 (ns) 68 (ns) 65 (ns) 2009 % (P-value) 84 (ns) 79 (ns) 80 (0.00) 88 (ns) 64 (ns) 63 (ns) 68 (ns) 2010 % (P-value) 88 (ns) 83 (ns) 92 (0.00) 90 (ns) 72 (ns) 71 (ns) 78 (0.03) 2011 % (P-value) 90 (ns) 85 (ns) 91 (ns) 93 (ns) 76 (ns) 74 (ns) 80 (ns) 2012 % (P-value) 86 (ns) 86 (ns) 93 (ns) 92 (ns) 72 (ns) 69 (ns) 78 (ns) TABLE-6: GSA 2 – Cenpatico Adult Consumer Survey Results by Domain for 2007 - 2012 Domain General Satisfaction Service Access Participation in Treatment Planning Service Quality & Appropriateness Outcomes Improved Functioning Social Connectedness 2007 % 87 80 79 87 78 73 74 2008 % (P-value) 84 (ns) 82 (ns) 86 (ns) 88 (ns) 71 (ns) 75 (ns) 75 (ns) 2009 % (P-value) 86 (ns) 81 (ns) 82 (ns) 89 (ns) 71 (ns) 67 (ns) 71 (ns) 2010 % (P-value) 91 (ns) 90 (0.02) 93 (0.00) 92 (ns) 81 (0.03) 75 (ns) 83 (0.01) 2011 % (P-value) 89 (ns) 88 (ns) 91 (ns) 90 (ns) 82 (ns) 77 (ns) 83 (ns) 2012 % (P-value) 88 (ns) 83 (ns) 92 (ns) 91 (ns) 69 (0.00) 70 (0.03) 80 (ns) TABLE-7: GSA 3 - Cenpatico Adult Consumer Survey Results by Domain for 2007 - 2012 Domain General Satisfaction Service Access Participation in Treatment Planning Service Quality & Appropriateness Outcomes Improved Functioning Social Connectedness Color Key statistically significant increase statistically significant decrease 11 2007 % 90 83 82 89 79 72 71 2008 % (P-value) 82 (0.01) 77 (ns) 87 (ns) 86 (ns) 68 (0.01) 73 (ns) 72 (ns) 2009 % (P-value) 83 (ns) 79 (ns) 79 (0.02) 88 (ns) 71 (ns) 71 (ns) 71 (ns) 2010 % (P-value) 86 (ns) 84 (ns) 88 (0.03) 88 (ns) 77 (ns) 72 (ns) 80 (0.05) 2011 % (P-value) 86 (ns) 86 (ns) 91 (ns) 88 (ns) 75 (ns) 73 (ns) 81 (ns) 2012 % (P-value) 89 (ns) 91 (ns) 94 (ns) 93 (ns) 81 (ns) 78 (ns) 88 (ns) 2012 Consumer Survey Report TABLE-8: GSA 4 - Cenpatico Adult Consumer Survey Results by Domain for 2007 - 2012 Domain General Satisfaction Service Access Participation in Treatment Planning Service Quality & Appropriateness Outcomes Improved Functioning Social Connectedness 2007 % 87 86 81 91 78 76 73 2008 % (P-value) 87 (ns) 83 (ns) 92 (0.01) 90 (ns) 73 (ns) 67 (0.04) 67 (ns) 2009 % (P-value) 86 (ns) 83 (ns) 84 (0.00) 89 (ns) 70 (ns) 64 (ns) 66 (ns) 2010 % (P-value) 87 (ns) 87 (ns) 92 (0.03) 90 (ns) 75 (ns) 73 (ns) 77 (0.02) 2011 % (P-value) 91 (ns) 89 (ns) 95 (ns) 93 (ns) 76 (ns) 70 (ns) 79 (ns) 2012 % (P-value) 93 (ns) 93 (ns) 94 (ns) 95 (ns) 82 (ns) 76 (ns) 81 (ns) TABLE-9: GSA 5 - CPSA Adult Consumer Survey Results by Domain for 2007 – 2012 Domain General Satisfaction Service Access Participation in Treatment Planning Service Quality & Appropriateness Outcomes Improved Functioning Social Connectedness 2007 % 85 78 78 89 70 64 64 2008 % (P-value) 83 (ns) 67 (0.01) 91 (0.00) 80 (0.00) 66 (ns) 64 (ns) 62 (ns) 2009 % (P-value) 78 (ns) 69 (ns) 78 (0.00) 87 (ns) 68 (ns) 65 (ns) 65 (ns) 2010 % (P-value) 87 (0.03) 79 (0.03) 92 (0.03) 90 (ns) 69 (ns) 68 (ns) 78 (0.01) 2011 % (P-value) 89 (ns) 85 (ns) 92 (ns) 91 (ns) 75 (ns) 72 (ns) 76 (ns) 2012 % (P-value) 87 (ns) 78 (0.02) 89 (ns) 85 (0.02) 75 (ns) 70 (ns) 75 (ns) TABLE-10: GSA 6 – Value Options in 2007 and Magellan 2008 - 2012 Adult Consumer Survey Results by Domain Domain General Satisfaction Service Access Participation in Treatment Planning Service Quality & Appropriateness Outcomes Improved Functioning Social Connectedness Color Key statistically significant increase statistically significant decrease 12 2007 % 87 83 83 90 77 67 67 2008 % (P-value) 80 (0.04) 71 (0.00) 87 (ns) 83 (0.02) 68 (0.03) 68 (ns) 69 (ns) 2009 % (P-value) 86 (ns) 82 (0.02) 85 (ns) 90 (ns) 73 (ns) 71 (ns) 69 (ns) 2010 % (P-value) 85 (ns) 79 (ns) 92 (0.05) 90 (ns) 77 (ns) 72 (ns) 79 (0.03) 2011 % (P-value) 83 (ns) 83 (ns) 82 (0.00) 84 (0.05) 68 (0.03) 65 (ns) 74 (ns) 2012 % (P-value) 83 (ns) 85 (ns) 89 (0.04) 84 (ns) 72 (ns) 65 (ns) 74 (ns) 2012 Consumer Survey Report Summary of the 2012 Adult Survey Results: Statewide:  The highest scoring domain in 2012 for the adult population is Participation in Treatment Planning and the lowest is Improved Functioning.  Participation in Treatment Planning domain improved by three percentage points representing a statistically significant increase (P<0.01) from 2011 to 2012.  Outcomes domain improved by two percentage points.  General Satisfaction, Service Access, and Service Quality & Appropriateness domains decreased by one percentage point.  Improved Functioning and Social Connectedness domains show no change from the 2011 results. RBHA Specific: 13  Magellan (GSA 6) showed a statistically significant increase in Participation in Treatment Planning domain by seven percentage points (P<0.04), which may be attributed to Magellan‟s initiatives during FY2012.  Cenpatico (GSA 2) showed statistically significant decreases in two domains: Outcomes by thirteen percentage points (P<0.00) and Improved Functioning by seven percentage points (P<0.03).  CPSA (GSA 5) experienced statistically significant decreases in two domains as well. Service Access domain fell seven percentage points (P<0.02) and Service Quality & Appropriateness domain fell six percentage points (P<0.02). 2012 Consumer Survey Report VIII. RBHA Specific Adult Initiatives Cenpatico and CPSA submitted to ADHS/DBHS some initiatives for the adult population to address deficiencies identified in their Consumer Survey report: Cenpatico recognized the statistically significant decreases in Outcomes and Functioning domains for GSA 2 and reported actions planned to address these areas.  Cenpatico developed a Performance Improvement Plan (PIP) in December 2011 that included the collection of a quarterly satisfaction survey to measure its consumer satisfaction with providers in each GSA.  Cenpatico will maintain this practice, and plans to enhance the survey in January 2013 with particular attention to these domains.  Feedback from the surveys will be shared with Cenpatico‟s QM Committee and its provider network each quarter.  After two quarters of collecting results from the new 2013 survey, Cenpatico will assess each of its geographic areas for the need of targeted interventions where the need for improvement is indicated. ADHS/DBHS will require Cenpatico to regularly report updates on these initiatives to ensure there is a positive impact and performance improvement. CPSA acknowledged the need for improvements specifically in the Service Access and Service Quality & Appropriateness domains. Listed below are steps CPSA is implementing to improve and meet the needs of consumers.        14 CPSA continues to maintain frequent communication with members to ensure coordination of, and access to, behavioral health services among Comprehensive Service Providers and other community resources. CPSA maintains an Audio Visual Library on the website that includes a comprehensive overview of member-centered educational materials intended to educate and empower members. CPSA will continue to improve its website to be more inclusive of information and training opportunities for members and families. CPSA shares these results with all Comprehensive Service Providers (CSP) and expects implementation of improvements in their systems to meet and exceed the needs of members. CPSA QM staff continues to audit comprehensive Service Provider medical charts and provide real-time feedback to Comprehensive Service Provider staff on key MHSIP indicators. CPSA Compliance Committee is working on issues around system-wide sub-contract tracking systems and any specific compliance issues that the CPSA Comprehensive Service Provider Team cannot resolve. CPSA continues to involve peers in the support of members through the Recovery Support Initiative and the development of Recovery Support Centers established within the CSPs. CPSA implemented a pilot program utilizing the Outcomes Rating Scale and the Session Rating Scale in order to elicit ongoing member feedback to improve treatment or service outcomes. 2012 Consumer Survey Report IX. YSS-F Survey Analysis and Results Demographics A total of 1,555 completed youth surveys were analyzed. The breakout of the respondents is reported by gender, age group, ethnicity, race, length of enrollment in services, and involvement in a Child and Family Team (CFT). Please see Attachment F, 2012 YSS-F Demographics for complete demographics information. Domain Line Item Analysis Line items are specific questions pertaining to each survey domain. Analysis of answers to each domain specific line item indicates the aspects of service delivery the respondents report as either positively or negatively affecting the overall domain score (Attachment G, 2012 YSS-F Line Item). Table-11 demonstrates the results of the 2012 YSS-F Survey and compares them to previous surveys. The t-test analysis was used to compare 2011 and 2012 to determine if there were any statistically significant differences between each domain‟s average scores. A P-value of 95% significance when less than or equal to 0.05 or “ns” for “not significant” is listed to reflect the change from the prior year. The statewide statistics are based on weighted scores. TABLE-11: Statewide Youth Consumer YSS-F Survey Results by Domain for 2007 – 2012 Domain General Satisfaction Service Access Participation in Treatment Planning Cultural Sensitivity Outcomes Improved Functioning Social Connectedness Color Key statistically significant increase statistically significant decrease 15 2007 % 78 78 90 92 58 61 82 2008 % (P-value) 77 (ns) 73 (ns) 87 (ns) 90 (ns) 60 (ns) 58 (ns) 79 (ns) 2009 % (P-value) 80 (ns) 76 (ns) 89 (ns) 90 (ns) 68 (ns) 66 (ns) 83 (ns) 2010 % (P-value) 85 (ns) 83 (ns) 92 (ns) 96 (0.05) 69 (ns) 71 (ns) 88 (ns) 2011 % (P-value) 82 (ns) 86 (ns) 94 (ns) 96 (ns) 65 (ns) 67 (ns) 89 (ns) 2012 % (P-value) 82 (ns) 86 (ns) 92 (0.02) 96 (ns) 62 (0.00) 68 (ns) 86 (0.03) 2012 Consumer Survey Report The 2012 statewide YSS-F Survey Results: General Satisfaction: Six questions were asked in the survey to ascertain General Satisfaction (Attachment G). The overall score for this domain is 82%. There were no increases or decreases in this domain compared to the 2011 survey results. Service Access: Two questions in the survey gathered information regarding Access to Services (Attachment G). The score for this domain is 86%. No increases or decreases were found in comparison to the 2011 results. Participation in Treatment Planning: The survey comprised three questions to indicate Participation in Treatment Planning (see Attachment G). The score for this domain is 92%, down two percentage points from 2011. This decrease is statistically significant (P<0.02). Cultural Sensitivity: Four questions in the survey focused on Cultural Sensitivity (Attachment G). The average score for this domain is 96%. There were no increases or decreases from 2011 to 2012 results. Outcomes: Eight questions were asked to get consumers‟ perception on Outcomes (Attachment G). The average score for this domain is 62% which is a decline of three percentage points from 2011. This decrease is statistically significant (P<0.00). Improved Functioning: Six questions indicate respondents‟ impressions of Improved Functioning (Attachment G). The average score for this domain is 68%, demonstrating a one percentage point increase from 2011. However this increase is not statistically significant. Social Connectedness: Four questions were asked in the survey to ascertain Social Connectedness (see Attachment G). This domain scored 86%, indicating a three percentage point decrease from 2011. This increase is statistically significant (P<0.03). RBHA and GSA specific YSS- F survey findings are presented in tables 12 through 17 (page 16 and 17); they include percentages and P-values for each domain by RBHA and GSA ranging from 2007 through 2012. 16 2012 Consumer Survey Report TABLE-12: GSA 1 - NARBHA Youth Consumer YSS-F Survey Results by Domain for 2007 - 2012 Domain General Satisfaction Service Access Participation in Treatment Planning Cultural Sensitivity Outcomes Improved Functioning Social Connectedness 2007 % 76 77 91 93 51 55 80 2008 % (P-value) 84 (ns) 81 (ns) 88 (ns) 93 (ns) 72 (0.00) 71 (0.00) 87 (ns) 2009 % (P-value) 83 (ns) 79 (ns) 92 (ns) 93 (ns) 67 (ns) 66 (ns) 87 (ns) 2010 % (P-value) 90 (ns) 90 (0.01) 93 (ns) 96 (ns) 70 (ns) 73 (ns) 91 (ns) 2011 % (P-value) 90 (ns) 94 (ns) 94 (ns) 97 (ns) 69 (ns) 71 (ns) 90 (ns) 2012 % (P-value) 85 (ns) 90 (ns) 93 (ns) 98 (ns) 65 (ns) 68 (ns) 92 (ns) TABLE-13: GSA 2 - Cenpatico Youth Consumer YSS-F Survey Results by Domain for 2007 - 2012 Domain General Satisfaction Service Access Participation in Treatment Planning Cultural Sensitivity Outcomes Improved Functioning Social Connectedness 2007 % 89 86 88 96 76 78 89 2008 % (P-value) 76 (0.00) 81 (ns) 86 (ns) 94 (ns) 70 (ns) 69 (0.03) 86 (ns) 2009 % (P-value) 81 (ns) 82 (ns) 94 (0.02) 93 (ns) 62 (ns) 61 (ns) 85 (ns) 2010 % (P-value) 82 (ns) 90 (0.04) 93 (ns) 99 (0.02) 69 (ns) 70 (ns) 89 (ns) 2011 % (P-value) 91 (0.02) 95 (ns) 96 (ns) 99 (ns) 71 (ns) 73 (ns) 97 (0.01) 2012 % (P-value) 89 (ns) 93 (ns) 93 (ns) 97 (ns) 75 (ns) 76 (ns) 94 (ns) TABLE-14: GSA 3 - Cenpatico Youth Consumer YSS-F Survey Results by Domain for 2007 - 2012 Domain General Satisfaction Service Access Participation in Treatment Planning Cultural Sensitivity Outcomes Improved Functioning Social Connectedness Color Key statistically significant increase statistically significant decrease 17 2007 % 77 74 88 90 65 65 77 2008 % (P-value) 74 (ns) 74 (ns) 80 (0.01) 89 (ns) 65 (ns) 62 (ns) 77 (ns) 2009 % (P-value) 75 (ns) 76 (ns) 88 (0.05) 89 (ns) 66 (ns) 65 (ns) 78 (ns) 2010 % (P-value) 87 (0.01) 90 (0.00) 90 (ns) 94 (ns) 77 (0.02) 79 (0.00) 87 (0.03) 2011 % (P-value) 86 (ns) 90 (ns) 89 (ns) 96 (ns) 73 (ns) 74 (ns) 87 (ns) 2012 % (P-value) 88 (ns) 93 (ns) 96 (0.00) 97 (ns) 71 (ns) 74 (ns) 91 (ns) 2012 Consumer Survey Report TABLE-15: GSA 4 - Cenpatico Youth Consumer YSS-F Survey Results by Domain for 2007 - 2012 Domain General Satisfaction Service Access Participation in Treatment Planning Cultural Sensitivity Outcomes Improved Functioning Social Connectedness 2007 % 78 86 92 91 66 68 82 2008 % (P-value) 78 (ns) 80 (ns) 90 (ns) 92 (ns) 61 (ns) 62 (ns) 87 (ns) 2009 % (P-value) 85 (ns) 91 (0.01) 98 (0.01) 96 (ns) 66 (ns) 65 (ns) 87 (ns) 2010 % (P-value) 80 (ns) 87 (ns) 91 (0.00) 95 (ns) 66 (ns) 69 (ns) 88 (ns) 2011 % (P-value) 84 (ns) 94 (0.04) 94 (ns) 97 (ns) 70 (ns) 71 (ns) 91 (ns) 2012 % (P-value) 82 (ns) 92 (ns) 92 (ns) 96 (ns) 63 (ns) 67 (ns) 88 (ns) TABLE-16: GSA 5 - CPSA Youth Consumer YSS-F Survey Results by Domain for 2007 2012 Domain General Satisfaction Service Access Participation in Treatment Planning Cultural Sensitivity Outcomes Improved Functioning Social Connectedness 2007 % 81 76 89 90 65 66 86 2008 % (P-value) 79 (ns) 73 (ns) 86 (ns) 90 (ns) 63 (ns) 62 (ns) 82 (ns) 2009 % (P-value) 82 (ns) 74 (ns) 86 (ns) 86 (ns) 72 (ns) 72 (0.04) 84 (ns) 2010 % (P-value) 81 (ns) 84 (0.02) 88 (ns) 94 (0.02) 62 (0.03) 66 (ns) 84 (ns) 2011 % (P-value) 88 (ns) 87 (ns) 93 (ns) 97 (ns) 68 (ns) 71 (ns) 90 (ns) 2012 % (P-value) 84 (ns) 81 (ns) 89 (ns) 91 (0.01) 62 (0.01) 66 (ns) 86 (ns) TABLE-17: GSA 6 - Value Options in 2007 and Magellan in 2008 – 2012 Youth Consumer YSS-F Survey Results by Domain Domain General Satisfaction Service Access Participation in Treatment Planning Cultural Sensitivity Outcomes Improved Functioning Social Connectedness Color Key statistically significant increase statistically significant decrease 18 2007 % 77 75 86 93 62 63 79 2008 % (P-value) 75 (ns) 70 (ns) 87 (ns) 90 (ns) 56 (ns) 53 (0.04) 75 (ns) 2009 % (P-value) 77 (ns) 73 (ns) 88 (ns) 91 (ns) 68 (0.02) 64 (0.03) 82 (ns) 2010 % (P-value) 86 (0.03) 80 (ns) 93 (ns) 98 (0.01) 71 (ns) 72 (ns) 88 (ns) 2011 % (P-value) 78 (0.02) 82 (ns) 94 (ns) 96 (ns) 61 (0.03) 63 (0.05) 88 (ns) 2012 % (P-value) 80 (ns) 87 (ns) 93 (ns) 97 (ns) 60 (ns) 60 (ns) 84 (ns) 2012 Consumer Survey Report Summary of the 2012 YSS-F Survey Results: Statewide:  Significant declines were noted in the 2012 statewide youth survey results compared to 2011.  Participation in Treatment Planning domain declined significantly by two percentage points (P<0.02).  Outcomes domain decreased statistically significant by three percentage points (P<0.00).  Social Connectedness domain fell significantly by three percentage points (P<0.03). Additionally,  Improved Functioning domain increased in score by one percentage point from 2011.  General Satisfaction, Service Access, and Cultural Sensitivity domains demonstrate no increases or decreases in comparison to the 2011 results. RBHA Specific: 19  Cenpatico (GSA 3) showed significant increase in Participation in Treatment Planning domain by seven percentage points (P<0.00) from 2011.  CPSA (GSA 5) experienced statistically significant declines in Cultural Sensitivity and Outcomes domains by six percentage points each from 2011. 2012 Consumer Survey Report X. RBHA Specific YSS-F Initiatives CPSA recognizes the statistically significant declines and has developed plans and activities to improve performance in the Cultural Sensitivity and Outcomes domains. 20  CPSA Cultural Competency Committee created supplemental materials for clinical staff and members to encourage the inclusion and documentation of cultural preferences in service planning and treatment, with support for language services as needed.  CPSA continues to implement the Meet Me Where I Am initiative that maintains children in home through the utilization of intensive community-based support and rehabilitation through Child and Family Support Services.  Quarterly Cultural Competency Committee meetings are held with all CSPs.  CSPs continue to incorporate MHSIP outcome indicators into forms that will be utilized at the beginning of every appointment to address where members are in treatment relative to outcomes attributable to treatment.  Providers are addressing the Outcomes Indicator language in the Child and Family Teams (CFT) agenda and reaching out to coaches to monitor the effectiveness of this initiative.  CSPs continue to maintain Electronic Medical Records to track members‟ progress while coordinating care with other agencies that are also addressing members‟ care.  CSPs created work groups comprised of Clinical and QM staff to address how to incorporate, identify, communicate and document outcomes with the Child and Family Team.  CSPs are creating Service Planning Training to create meaningful measures and goals with members and families.  CSPs implemented the Customer/Cultural Liaison positions to focus on customer satisfaction.  CSPs implemented consumer advisory boards for consumer‟s voices to provide the highest quality services. 2012 Consumer Survey Report XI. Statewide Improvement Opportunities ADHS/DBHS recognizes the opportunity to use the information from the 2012 survey results to make system improvements, and will implement statewide initiatives with the RBHAs to continue to improve scores for each domain. Special attention will be placed around the Outcomes and Improved Functioning domains, which continue to receive the lowest scores from both Adults and Children. In addition to general statewide initiatives, RBHA-specific activities are undertaken as part of standard ADHS/DBHS processes, as appropriate. Survey results are shared with the RBHAs, and they are required to respond with analysis of any problem areas, along with plans for improvement. ADHS/DBHS reviews their conclusions and plans, and monitors implementation and progress. XII. ADHS/DBHS Initiatives Below are ADHS/DBHS initiatives for both the Children and Adult systems of care that address Outcomes, Improved Functioning, Service Access and Social Connectedness: Adult Initiatives:  The 2012-2014 ADHS/DBHS Adult System of Care (ASOC)-Strategic Plan (SP) establishes goals and objectives for statewide network development priorities in part through a review of State and GSA network analysis, review of data sets, community input, and the identification of best practices efforts that are designed to assist individuals moving through recovery and increasing the quality of life outcomes. The analyses of the ASOC-strategic plan and the 2010 and 2011 Adult and Youth Consumer Survey identified similar priorities. For example: o An objective in the ASOC-SP is to increase the employment rate for persons with Serious Mental Illness (SMI), General Mental Health (GMH) and Substance Abuse (SA). The Outcomes domain of the Consumer Survey addresses a person‟s ability to: 1) control his/her life, 2) operate in school, and work environment, and 3) do better in social situations; by achieving the improvement in employment rate in ASOC-SP, ADHS/DBHS expects an increase in the Outcomes domain. o The ASOC-SP includes an objective to increase the percentage of peers and family members satisfied with their access to services which was identified as an area needing improvement in the Consumer Survey Report. Additionally, ASOC-SP includes strategies to conduct statewide discussion on the awareness and community needs around Trauma Informed Care. System Initiatives:  21 ADHS/DBHS, along with family member and recipient input, developed the Behavioral Health System Performance Framework and Dashboard as a means to evaluate the effectiveness of the system using standardized measures, such as family 2012 Consumer Survey Report and recipient identified outcomes, the National Outcomes Measures (NOMs) and ADHS/DBHS/BQMO performance metrics.  ADHS/DBHS continues to routinely update its Behavioral Health System Performance Framework and Dashboard, providing transparency, accountability, and increased consumer education regarding ADHS/DBHS performance measures. Children’s Initiatives: 22  ADHS/DBHS continues to use the System of Care Practice Review (SOCPR) process developed by the University of South Florida to assess Child and Family Team (CFT) practice for youth and families with complex needs. These intensive case reviews include outcomes-focused questions to ensure CFTs are identifying and tracking outcomes as well as evaluating the effectiveness of provided services and improved functioning. Consumer Survey results are shared with all divisions at DBHS, including the Children‟s System of Care so the areas needing improvement can be addressed. 180 SOCPR reviews were conducted last year with another 180 scheduled for FY13. There were also more than one thousand Brief Practice Reviews (BPR‟s) conducted via telephonic interviews with caregivers. The reviews are conducted at the individual provider level and are used to develop annual performance improvement plans. The plans are approved by DBHS and monitored by the RBHA with regular updates provided to DBHS.  For FY10, ADHS/DBHS earmarked approximately five million dollars of additional funding to the RBHAs to increase the number of case managers with reduced caseloads. During the course of FY10, there was an increase of approximately 104 case managers statewide serving children with complex needs. In total this focused effort has developed approximately 469 case managers statewide as of the end of the FY11 fiscal year. ADHS/DBHS continues to monitor the availability of case managers with reduced caseloads for children with complex needs.  The continued emphasis on in-home direct support services, as established by the Meet Me Where I Am (MMWIA) Campaign, has been a valuable resource to children and families with the most complex needs. These services put direct support workers in homes, schools and communities at the times and for as many hours as necessary to meet the family‟s needs, leading to improved functioning and better outcomes.  ADHS/DBHS continues to monitor and promote development of generalist direct support programming through the use of a SE Modifier to track encounter activity and through regular program updates.  ADHS/DBHS continues to promote family and youth involvement in the Children‟s Behavioral Health System. In partnership with family-run organizations, efforts are focused on building and sustaining an infrastructure and agency culture to support and involve youth and family members at all levels of the system. During FY13 a particular emphasis will be placed on supporting the certification process for peer mentors in order to more formally integrate those services into the developing system of care. Additionally the newly revised Youth Involvement Practice Protocol will continue to strengthen the youth and family involvement in the system of care. 2012 Consumer Survey Report 23  The annual Children‟s System of Care (CSOC) Strategic Plan (SP) provides a vehicle for the Division and RBHAs to address key goals around CFT Practice Model monitoring through the Practice Review process, and development of youth and family involvement and leadership, Generalist Direct Support services and High Needs Case Management services to work with children and families with the most complex needs.  The strategic activities prioritized in CSOC-SP continue to promote family driven care as well as youth and family involvement in local and statewide committees and system development activities. Focus is placed on specific populations such as children ages birth to 5, transition aged youth, and youth with substance use disorders in order to more clearly define their needs and help providers develop expertise in working with these youth. 2012 Consumer Survey Report XIII. Conclusion The Annual Consumer Surveys are a valuable source of information, providing direct feedback from members about their experience with behavioral health services. The results identify areas of satisfaction as well as opportunities for improvement. The Participation in Treatment Planning and Service Quality & Appropriateness domains have had the most favorable statewide results in the Adult Survey for each of the last three years, while Outcomes, Improved Functioning, and Social Connectedness have consistently shown the most room for improvement. The Children‟s Survey has reflected statewide satisfaction levels of over 90 percent in the Participation in Treatment Planning and Cultural Sensitivity domains for the last three years; the results for the Outcomes and Improved Functioning domains have been the lowest statewide scores of all domains for that population for every year of the Survey. This year‟s 2012 adult statewide Survey results show Improved Functioning and Social Connectedness domains with no change in score from 2011. Participation in Treatment Planning domain demonstrated a significant increase by three percentage points (P<0.01). The Outcomes domain presented improvement from 2011; however, this increase is not statistically significant. The highest scoring domain for the adult population in 2012 is Participation in Treatment Planning and the lowest is the Improved Functioning domain. In the 2012 adult survey at the RBHA/GSA level, Magellan (GSA 6) showed a statistically significant increase in Participation in Treatment Planning domain by seven percentage points (P<0.04), which may be attributed to Magellan‟s initiatives during FY2012. Cenpatico (GSA 2) showed statistically significant decreases in two domains: Outcomes by thirteen percentage points and Improved Functioning by seven percentage points. CPSA (GSA 5) experienced statistically significant decreases in two domains as well. Service Access domain fell seven percentage points (P<0.02) and Service Quality and Appropriateness domain fell six percentage points (P<0.02). Significant declines were noted in the 2012 statewide youth survey. Participation in Treatment Planning fell two percentage points (P<0.02), Outcomes fell three percentage points (P<0.00) and Social Connectedness fell three percentage points (P<0.03) compared to 2011. At the RBHA/GSA level on the children‟s 2012 survey, Cenpatico (GSA 3) showed a significant increase in Participation in Treatment Planning domain by seven percentage points (P<0.00). CPSA (GSA 5) experienced statistically significant decreases in two domains: Cultural Sensitivity and Outcomes domains fell six percentage points each from 2011 (P<0.01). Initiatives have been developed by ADHS/DBHS to address areas of concern reflected in the Survey results, specifically the Outcomes, Improved Functioning, Service Access, and Social Connectedness domains. Both the Adult and Children‟s System of Care Strategic Plans are informed by Survey results. Standardized measures are shared with DBHS stakeholders through the Behavioral Health System Performance Framework and Dashboard. In addition, there are RBHA-specific activities. Cenpatico is enhancing an existing Performance Improvement Project and its quarterly satisfaction survey to better identify the need for targeted interventions. CPSA maintains frequent contact with members and has implemented feedback 24 2012 Consumer Survey Report through rating scales to enhance treatment and service outcomes. ADHS/DBHS will monitor and work closely with these RBHAs to improve member satisfaction. As per the ADHS/DBHS Contract with the RBHAs, satisfaction with service Outcomes on the Annual Consumer Survey is a performance incentive; a score of 70% or greater on the Outcomes domain of the Consumer Survey makes up 25% of the incentive award. Adult and Youth survey results are evaluated independently, each contributing to half of the award. ADHS/DBHS believes that assisting members in the identification and tracking of treatment outcomes is imperative to improving behavioral health recipients‟ overall perception of the quality of services they receive. 25 2012 Consumer Survey Report ATTACHMENT-A 26 2012 Consumer Survey Report 2012 Tribal Behavioral Health Survey Results Arizona Tribal Behavioral Health Authorities (TBHAs) Gila River Indian Community, Pascua Yaqui Centered Spirit Program, Navajo Nation and White Mountain Apache Tribe participated in the 2012 Consumers Survey. The Tribal BHAs have shown an overall slight decrease in participation from 438 participants in 2011 to 433 in 2012. All Tribal BHAs conduct a convenience sampling of their enrolled members. The number of surveys completed by tribal participants varied this year, Gila River and Pascua Yaqui increased while Navajo Nation and White Mountain Apache Tribes decreased. Number of Surveys Completed TBHA Gila River Navajo Nation Pascua Yaqui White Mountain Apache Total TBHA Adult Survey 95 YSS-F 22 Total 117 87 16 103 106 42 330 61 4 103 167 46 433 Methodology and Survey Administration A convenience sampling methodology was used (rather than a random sampling); therefore, all persons enrolled with the TBHAs were eligible for participation in the survey. Data Analysis TBHAs results were submitted directly to ADHS/DBHS and entered into the database; analysis was conducted by ADHS/DBHS staff in the Office of Information Management. Summary of Results: Social Connectedness domain demonstrates the highest degree of progress for adults receiving services through Tribal BHAs in 2012 compared to 2011. Outcomes and Improved Functioning domains remain the lowest rate of satisfaction amongst TBHA adults. Outcomes and Improved Functioning domains indicate the greatest rate of improvements for the families of youth receiving services through the Tribal BHAs in 2012 compared to the 2011 survey results. However, Outcomes and Improved Functioning domains continue to remain the lowest rates of satisfaction reported from families of youth receiving services through the Tribal BHAs. 27 2012 Consumer Survey Report Summary of 2010 to 2012 Tribal Behavioral Health Authorities Results for Adults General Satisfaction TBHA 2010 Gila River Navajo Nation Pascua Yaqui White Mtn Apache 2011 Participation in Treatment Planning Service Access 2012 2010 2011 2012 Service Quality & Appropriateness Improved Functioning Outcomes Social Connectedness 2010 2011 2012 2010 2011 2012 2010 2011 2012 2010 2011 2012 2010 2011 2012 93% 92% 89% 90% 85% 81% 92% 92% 85% 90% 96% 83% 77% 84% 68% 74% 84% 70% 88% 85% 85% 89% 91% 85% 80% 80% 85% 79% 89% 88% 85% 88% 87% 73% 82% 75% 76% 83% 80% 75% 86% 87% 95% 94% 94% 94% 86% 92% 89% 90% 89% 94% 93% 92% 87% 82% 82% 88% 78% 84% 91% 85% 91% 91% 93% 93% 95% 96% 87% 86% 86% 87% 91% 86% 88% 86% 76% 87% 83% 86% 80% 100% 90% 93% TBHA scores are not included in statewide numbers due to TBHA convenience sampling methodology. Summary of 2010 to 2012 Tribal Behavioral Health Authorities Results for Youth General Satisfaction TBHA Gila River Navajo Nation Pascua Yaqui White Mtn Apache Participation in Treatment Planning Service Access Cultural Sensitivity 2010 2011 2012 2010 2011 2012 2010 2011 2012 2010 2011 2012 2010 2011 91% 82% 86% 91% 86% 96% 97% 96% 91% 97% 100% 100% 57% 64% 86% 84% 94% 75% 72% 88% 78% 87% 88% 78% 91% 94% 75% 84% 96% 93% 100% 100% 92% 84% 95% 92% 98% 100% 97% 89% 100% 100% 100% 90% 100% 89% 90% 100% 100% 100% 100% TBHA scores are not included in statewide numbers due to TBHA convenience sampling methodology. 28 Improved Functioning Outcomes 2012 Social Connectedness 2010 2011 2012 2010 2011 2012 68% 57% 64% 68% 94% 96% 96% 73% 94% 75% 75% 94% 72% 91% 94% 58% 71% 93% 65% 75% 93% 93% 95% 95% 67% 85% 100% 67% 85% 100% 78% 95% 100% 2012 Consumer Survey Report ATTACHMENT-B 29 2012 Consumer Survey Report STATEWIDE CONSUMER SURVEY PROTOCOL 2012 Prepared by: Carolyn Dempsey, PI Specialist, Quality Management Operations, DBHS Rahnuma Khandaker, Utilization Data Analyst, Quality Management Operations, DBHS Division of Behavioral Health Services 30 2012 Consumer Survey Report Executive Summary The protocol for the 2012 consumer survey is based on the methodological and administrative guidelines followed in recent years. Two consumer surveys will be administered again in 2012; one for adults and one for the Parents/guardians of children receiving behavioral health services. The survey will be available to consumers in two languages: English and Spanish. Survey data will be entered into an SPSS database by the Regional Behavioral Health Authorities (RBHAs) and forwarded to the Arizona Department of Health Services/Division of Behavioral Health Services (ADHS/DBHS). Prior to implementation of the 2012 survey, ADHS/DBHS will provide each Geographic Service Area (GSA) with the CIS (Client Information System) Client IDs for 500 adult consumers and 400 to 500 youth consumers who the RBHAs/providers will encourage to participate in the survey. Each CIS Client ID will be linked to a Survey ID reference number to allow for tracking of which consumers completed a survey. The survey will be administered during April and May 2012. As in previous years, the primary administration route will be to distribute the survey at the provider sites. As the consumer checks in for their appointment, the survey questionnaire will be handed to them. The consumer will be requested to complete the questionnaire prior to their appointment, but will be allowed to finalize the survey after the appointment if needed, or be provided with an addressed, stamped envelope to mail the survey in to the RBHA if they did not have time to complete it in the office. A drop box will be provided at each provider site for consumers to drop off their completed surveys. In cases where consumers who are selected for the sample have home appointments (as opposed to clinic appointments) during the survey timeframe, the questionnaire will be completed at home and mailed using the addressed, stamped envelope to be provided with the survey. If the consumer does not have a clinic or home appointment scheduled during the survey administration period or no-shows for a scheduled appointment, a non-clinical staff at the RBHA may conduct the survey by phone. Providers will never have access to completed surveys or individual survey results. ADHS has the statewide oversight responsibility for implementation and analysis of the survey data. The RBHAs will be responsible for ensuring that providers strictly adhere to the protocol. The providers are primarily responsible for the survey administration. Survey Instruments Two MHSIP survey instruments are the Adult Consumer Survey and the Youth Services Survey for Families (YSS-F). The adult survey will be administered to adult consumers of behavioral health services and the YSS-F will be administered to parents/guardians of children receiving behavioral health services. 31 2012 Consumer Survey Report The MHSIP Adult Consumer Survey measures seven domains: (1) Service Accessibility; (2) Service Quality or Appropriateness (which includes one item concerning cultural sensitivity); (3) Consumer Participation in Treatment Planning; (4) Outcomes; (5) General Satisfaction; (6) Improved Functioning; and (7) Social Connectedness. In addition, the questionnaire includes a module of questions to determine the impact of services received on the recipient‟s involvement with the criminal justice system. All questions are scored using a Likert Scale of 1 through 5 as follows: 5=Strongly Agree, 4=Agree, 3=Neutral, 2=Disagree, and 1=Strongly Disagree. A Not Applicable option is also available if the question does not apply. In addition to the state-added question related to cultural sensitivity, two state-added questions initially included in the 2011 Adult survey tool to gather information specific to National CLAS Standards (Culturally and Linguistically Appropriate Services) will be retained this year. The three state-added questions in the Adult survey tool are: Q37 – In creating my service plan my cultural preferences were included. (For example: values, traditions, beliefs, race, language, etc.) Q38 – Services were provided in a language I understood. Q39 – In creating my service plan our tribal customs and beliefs were included. (For example: being asked to participate in traditional healing practices.) The MHSIP YSS-F focuses on the following seven domain areas: (1) Service Accessibility; (2) Participation in Treatment Planning; (3) Cultural Sensitivity; (4) Satisfaction with Services; (5) Outcomes; (6) Social Connectedness; and (7) Improved Functioning. Additional questions solicit information about the youth‟s criminal justice contact and school attendance. Questions are scored with a five-point Likert Scale where 5=Strongly Agree, 4=Agree, 3=Neutral, 2=Disagree, and 1=Strongly Disagree. A Not Applicable option is also available if the question does not apply. As with the Adult tool, in addition to the state-added question related to cultural sensitivity, two state-added questions included in the 2011 YSS-F tool to gather information specific to National CLAS Standards (Culturally and Linguistically Appropriate Services) will be retained this year. The three state-added questions in the YSS-F tool are: Q29 – In creating my child‟s service plan our cultural preferences were included (For example: values, traditions, beliefs, race, language, etc.) Q30 – Services were provided in a language my child understood. Q31 – In creating my child‟s service plan our tribal customs and beliefs were included. (For example: being asked to participate in traditional healing practices.) The RBHA and/or provider may pre-print the following information on the survey tool prior to distribution to client:  RBHA Name  Provider Name  Survey Id  Provider Facility ID 32 2012 Consumer Survey Report     Behavioral Health Category Entitlement Status (Title XIX or XXI) Distribution Method (Home, Clinic, or Phone) Client enrollment with DDD Both survey tools have four main sections: (1) demographic section, (2) MHSIP survey questions, (3) state-added questions, and (4) open-ended qualitative section. The demographic section provides descriptive information about the consumer‟s age, gender, race, ethnicity, and relationship of the person completing the survey to the service recipient. The second section of the survey contains the MHSIP standardized questions. They serve as benchmark tools to compare consumer perception of behavioral health systems across the nation. The third section consists of state-added questions to elicit consumer input regarding the inclusion of cultural preferences in the consumer‟s treatment planning and to provide information relative to the National CLAS Standards. The fourth and final section of the survey contains open-ended questions to solicit consumer comments. Two questions are asked of consumers – focusing on identifying what has been most helpful with their services, and what the consumer believes would improve services. The section entitled other comments is intended to provide consumers with an additional area on the survey to provide open-ended feedback on any issue. Confidentiality The front page of the survey questionnaire addresses confidentiality of the responses. Survey results are aggregated and not presented at an individual consumer level. The providers will never have access to completed surveys or individual survey results. Thematic analysis is conducted on written comments. Non-mandatory (Voluntary) The survey questionnaire likewise informs the respondent that participation in the survey is voluntary; every individual can choose to participate or not. It also notifies the respondent that non-participation will not affect the services they are currently or will receive in the future. Participating in the survey is one way the consumer may help improve the system they use. Languages The survey will be available to consumers in English and Spanish languages. Each survey form will be printed in English on one side and Spanish on the reverse side. For consumers with limited English proficiency and speak a language other than Spanish, the RBHA and/or the provider administering the survey will extend their best effort to translate the survey in the consumer‟s preferred language by utilizing the Language Line or other translation/interpretation 33 2012 Consumer Survey Report services officially utilized by the RBHA or their provider. The extent of assistance provided in language translation should not attempt to define what the question means. Sampling Design Sample Frame The sample frame refers to the population eligible to take the survey. This is the pool from which ADHS/DBHS will randomly select the sampled population. ADHS/DBHS will create an adult and a youth sample from the CIS database for each GSA. The adult clients may be enrolled in any program: General Mental Health, Substance Abuse, or Seriously Mentally Ill. Clients turning age 18 between October 1, 2011 and the end of the survey period, May 25, 2012, will be filtered out of the sample frame. The sample frame will be composed of: (a) Client must have an open Episode of Care (EOC) in FY2012; (b) Client must be Title XIX or Title XXI eligible in FY2012; (c) Client must have received a mental health service other than inpatient, transportation, laboratory and/or radiology services, or crisis; (d) The service must have occurred in the previous 6 months. Drawing of sample ADHS/DBHS will create a random sample and provide each GSA with a list of 500 adult and 400 to 500 youth clients to be surveyed. Administering survey ADHS/DBHS will provide the RBHAs with a list of randomly selected clients. The RBHA will duplicate the Survey ID number on the survey tool to be offered that specific consumer. To protect the confidentiality of the consumer, none of the parties privy to this information (DBHS, RBHA, Provider) will link the survey responses to consumers. ADHS/DBHS will provide the RBHAs with a database to store the survey results. The RBHA will disseminate the surveys; track which consumers have completed the survey; track why surveys were not completed; enter the survey data into the provided database; and submit to ADHS/DBHS: the completed paper surveys, the database containing all survey results, the database detailing which consumers completed a survey and for every consumer that did not complete a survey, the reason the survey was not completed. The RBHAs will enter data into the two ADHS/DBHS provided databases but the RBHAs will not alter the databases in any way. 34 2012 Consumer Survey Report The provider agency is responsible for identifying the specific provider location or site from which the consumer is presently receiving services. Survey Methodology Distribution Method The primary distribution method is a non-clinical staff at the provider office (i.e., clinic) handing the survey questionnaire to the consumer. As the consumer checks in for their appointment, s/he will be provided with a copy of the survey questionnaire to complete. If the consumer agrees to participate, s/he will be requested to complete the survey prior to his/her appointment. If the consumer is unable to complete the questionnaire, s/he will be allowed to finish it on site after the appointment or be provided with an addressed, stamped envelope to mail the survey in if they did not have time to complete it in the office. A drop box will be provided on site for completed surveys. Additionally, a specific area at the provider office will be designated for completing the survey. If the individual randomly selected has a scheduled appointment at home during the survey window, the provider staff will bring the survey questionnaire at the appointment date. If the consumer agrees to participate, s/he will be advised to complete the survey after the staff leaves and to mail the completed questionnaire to the RBHA using the pre-addressed, stamped envelope provided with the survey. If the individual does not have an appointment during the survey window, a non-clinical staff at the RBHA may conduct the survey over the phone. As an alternative, a non-clinical staff at the provider site may contact the consumer by phone to ask for their participation in the survey, offering a return envelope for the completed survey to be mailed. All return envelopes provided as a means for the consumer to submit their completed survey must be addressed to the RBHA. A check box in the questionnaire will be used to track the distribution method. The adult survey will be administered to the adult consumer. If the individual requests assistance, a guardian may complete the questionnaire on the consumer‟s behalf. The YSS-F will be administered to the parent/guardian of the child receiving services. If the parent or guardian is not at the appointment, then the survey will not be provided. List of Survey Clients ADHS/DBHS will provide each RBHA with a list of survey consumers to track those who complete a survey or the reason they did not complete a survey. The list of survey consumers will contain fields for:      35 RBHA ID Contractor ID Survey ID AHCCCS ID Last Name 2012 Consumer Survey Report         First Name Date of Birth Sex Survey Offered Date Survey Completed Date Reason Not Completed Provider ID Client contact phone number The RBHAs will submit their lists of survey clients to ADHS/DBHS bi-weekly throughout the survey administration period to keep ADHS/DBHS informed regarding the status of response rates and reasons for non-participation of sampled consumers. Due dates for submission of biweekly lists are included in the Timeline Attachment to this Protocol. Since this document contains protected health information, it will be treated as a confidential document. ADHS/DBHS Post-administration Follow-up During the survey administration period, RBHAs will attempt to achieve participation of all consumers on its list of survey clients. Every effort will be made to separate service delivery from sample collection. At the end of the administration period, RBHAs will provide ADHS/DBHS with the completed list of survey consumers indicating which consumers completed the survey and which did not, with the reasons and a contact phone number for those who did not participate. At that point, the RBHA will delete the list of survey consumers. RBHAs will submit to ADHS/DBHS the completed paper surveys, retaining copies for reference, and databases containing survey results by July 27, 2012. Tribal RBHAs participate in the Annual Consumer Survey by way of a convenience sampling of their enrolled consumers. These entities will be provided a master survey tool for each population that can be copied for distribution. Tribal RBHAs will submit to ADHS/DBHS the completed paper surveys, retaining copies for reference, by July 27, 2012. Survey Administration Survey Timeframe The survey will be administered for a period of eight weeks: April 2 through May 25, 2012. Roles and Responsibilities ADHS/DBHS is responsible for the statewide oversight of the survey administration to ensure consistent implementation of the survey protocol. The protocol, client sample, survey instruments, and survey results database will be created by ADHS/DBHS. ADHS/DBHS will 36 2012 Consumer Survey Report provide technical assistance throughout the survey process. Periodic monitoring, training, timelines, and use of checklist will be utilized to guide the T/RBHAs on critical points in the process. The T/RBHAs have the primary responsibility for ensuring that the protocol is precisely followed within their geographic regions. Direct oversight and assistance will be provided by the T/RBHAs to their providers. The T/RBHAs will ensure that the providers are appropriately trained and prepared to administer the survey. The RBHAs will enter data into the two ADHS/DBHS provided databases but the RBHAs will not alter the databases in any way including creating tables, changing the names of tables or fields, or creating a different value coding scheme. Each provider agency is primarily responsible for each of its sites in which the survey is to be administered. Each site will maintain all necessary materials for survey administration. At each site, a drop box and a designated area will be provided for consumers to complete the survey. Providers will also be responsible for the day-to-day operations – including having the survey tools, materials for completing the survey (pens, pencils, clipboards), envelopes for return of the survey if needed, assigned resources for administration and collection of data for the survey. Non-Randomly Selected Consumers (Walk-in Requests) ADHS/DBHS does not require the RBHAs to extend survey participation efforts beyond the randomly selected populations but at the individual discretion of each RBHA/GSA, the RBHA may furnish its provider agencies with survey forms to give consumers who express a desire to participate in the survey but whose names do not appear on the lists of survey consumers (i.e., the consumer was not randomly selected). However, to maintain the scientific rigor of the protocol, the survey questionnaire completed by this group of respondents will be tracked separately by the RBHA. Names of individuals who belong to this group will not be added to the survey client list. This group will be tracked in some other ways as described in the succeeding paragraph. If the RBHA elects to collect responses from non-selected consumers, the same protocol will be followed for this group of respondents but the staff administering the survey will ensure that these “voluntary” surveys are kept separate from those on the lists of survey clients (randomly selected consumers). Several control measures will be used. First, consumers that are not randomly selected to participate in the survey (i.e., walk-in respondents) will be given a copy of the survey questionnaire with the pre-filled section of the questionnaire not completed. Second, the survey questionnaire that will be used for non-randomly selected consumers will be colorcoded. (Note: Surveys for the random sample will be printed on white paper.) RBHAs will enter the responses on the voluntary surveys into the same database as the results of the selected respondents, using the correct indicator, “C” for control (selected) respondents and “V” for voluntary (non-selected) respondents. 37 2012 Consumer Survey Report Pre-Survey Activities Notification to Consumers about the Survey To encourage greater participation, efforts will be made to inform consumers in advance about the survey. T/RBHAs and providers will be encouraged to utilize all or a combination of any of the following media: flyers, posters, website announcements, or other promotional materials. A staff member or members at each provider site will be assigned to work on the survey. In addition to daily survey administrative duties, a component of the staff member‟s role will include assisting consumers with the survey if necessary. Assistance may include: reading the survey to individuals unable to read, explaining the Likert scale used for scoring answers, emphasizing confidentiality of the survey, or ensuring consumers that participation in the survey is voluntary. Staff will be allowed to provide administrative assistance to the consumer, or provide encouragement to participate in the survey process. However, staff will not be able to explain the meaning of particular questions or provide interpretations on what particular questions mean. Data Management and Reporting Scoring Protocol The scoring protocol recommended by MHSIP will be utilized for evaluating the domain areas within the survey, as follows: 1. Recode ratings of „not applicable‟ as missing values. 2. For each survey, exclude domains where more than one-third of the domain questions are missing. 3. Calculate the mean of the items for each respondent. 4. Calculate the percent of scores that are greater than 3.5 Technical assistance ADHS will provide technical assistance to the RBHAs as needed. Response Rate Calculation: The rate will be calculated for each population for each GSA using the formula: Response rate = A / B Where: A= Total number of surveys returned B= Total number of clients in sample that were contacted and asked to participate in the survey 38 2012 Consumer Survey Report Weighting methodology The statewide data will be weighted by GSA client population to compensate for the stratified sample collection. Weights will be applied to the survey data prior to any statewide data analysis. Dissemination of Findings The following methods have been identified to circulate findings: Reporting of survey results in management meetings – Executive Management, Quality Management, Human Rights Committees, Behavioral Health Planning Council, other consumer advocate groups, and other interest groups that may be identified  Dissemination of information by providers to their local communities  Having copies of the survey available at the provider sites  Publishing results of survey on ADHS, RBHA and provider websites  39 2012 Consumer Survey Report ATTACHMENT-C Raw Data 40 2012 Consumer Survey Report Arizona Department of Health Services Division of Behavioral Health Services 2012 Annual Consumer Survey Raw Data Assumptions for interpreting data: 1. Denominator – Number of responses to specific domain or question on completed/analyzed surveys. 2. Numerator – Number of positive responses to specific domain or question on completed/analyzed surveys. 3. RBHA – Specific numbers and percentages are based on actual valid survey returns. 4. Statewide RBHA numbers and percentages are based on weighted scores. 5. Tribal BHA scores are not included in statewide numbers/percentages due to Tribal BHA convenience sampling methodology. 6. Weighting: As a result, if weighting were not applied for the statewide performance calculation, a GSA with a relatively smaller population would be over represented and a GSA with a larger population would be under represented. The weight applied to each GSA is determined by the number of clients enrolled in the GSA. Weighting is utilized to correct the sample design when describing statewide data. Each GSA is provided a similar number of surveys to have completed but the GSAs have very different population sizes. The table below details the specific weighting factors used: RBHA 7 26 Total RBHA Surveys Population 1,825 24,075 1,825 18,264 RBHA Total Surveys Population 295 58,632 308 58,632 Equation Weight (1825*24075)/(295*58632) (1825*18264)/(308*58632) 2.54023 1.84575 Adult 15 22 2 32 1,825 1,825 1,825 1,825 10,252 2,422 1,589 2,030 354 275 290 303 58,632 58,632 58,632 58,632 (1825*10252)/(354*58632) (1825*2422)/(275*58632) (1825*1589)/(290*58632) (1825*2030)/(303*58632) 0.90143 0.27414 0.17055 0.20854 Youth 7 26 15 22 32 2 1,555 1,555 1,555 1,555 1,555 1,555 16,585 8,879 4,384 1,533 1,065 711 280 204 381 303 241 146 33,157 33,157 33,157 33,157 33,157 33,157 (1555*16585)/(280*33157) (1555*8879)/(204*33157) (1555*4384)/(381*33157) (1555*1533)/(303*33157) (1555*1065)/(241*33157) (1555*711)/(146*33157) 2.77787 2.04122 0.53964 0.23728 0.20725 0.22839 41 2012 Consumer Survey Report 2012 MHSIP Consumer Survey Numbers Used in Calculation of Performance ADULT SURVEY RESULTS BY T/RBHA & MHSIP DOMAIN Domain: General Satisfaction T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Gila River Navajo Nation Pascua Yaqui White Mountain Apache Denominator 347 288 301 273 304 288 1,792 94 87 103 40 Numerator 297 253 267 255 263 239 1,529 84 74 97 37 Positive Response Percentage 85.6% 87.8% 88.7% 93.4% 86.5% 83.0% 85.3% 89.4% 85.1% 94.2% 92.5% Denominator 347 287 299 274 301 283 1,774 93 87 103 38 Numerator 297 239 272 256 234 239 1,474 75 74 95 33 Positive Response Percentage 85.6% 83.3% 91.0% 93.4% 77.7% 84.5% 83.1% 80.6% 85.1% 92.2% 86.8% Numerator 317 262 265 252 253 237 1,524 75 76 84 33 Positive Response Percentage 93.2% 92.3% 94.3% 94.4% 88.5% 88.8% 90.0% 85.2% 88.4% 89.4% 86.8% Domain: Service Access T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Gila River Navajo Nation Pascua Yaqui White Mountain Apache Domain: Participation in Treatment Planning T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Gila River Navajo Nation Pascua Yaqui White Mountain Apache 42 Denominator 340 284 281 267 286 267 1,693 88 86 94 38 2012 Consumer Survey Report Domain: Service Quality & Appropriateness T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Gila River Navajo Nation Pascua Yaqui Whtie Mountain Apache Denominator 348 287 291 266 297 278 1,751 92 86 101 40 Numerator 319 260 270 253 252 234 1,517 76 75 93 35 Positive Response Percentage 91.7% 90.6% 92.8% 95.1% 84.8% 84.2% 86.6% 82.6% 87.2% 92.1% 87.5% Denominator 338 281 282 267 291 278 1,728 91 87 101 39 Numerator 244 194 227 218 218 201 1,273 62 65 83 34 Positive Response Percentage 72.2% 69.0% 80.5% 81.6% 74.9% 72.3% 73.7% 68.1% 74.7% 82.2% 87.2% Denominator 339 285 291 265 291 269 1,708 91 86 100 39 Numerator 233 198 227 201 205 176 1,172 64 69 84 31 Positive Response Percentage 68.7% 69.5% 78.0% 75.8% 70.4% 65.4% 68.6% 70.3% 80.2% 84.0% 79.5% Denominator 338 280 288 266 292 277 Numerator 264 225 252 214 219 206 Positive Response Percentage 78.1% 80.4% 87.5% 80.5% 75.0% 74.4% Domain: Outcomes T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Gila River Navajo Nation Pascua Yaqui Whtie Mountain Apache Domain: Improved Functioning T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Gila River Navajo Nation Pascua Yaqui White Mountain Apache Domain: Social Connectedness T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 GSA 5 - CPSA GSA 6 - Magellan 43 2012 Consumer Survey Report Statewide RBHA Gila River Navajo Nation Pascua Yaqui White Mountain Apache 1,728 93 86 105 40 1,315 79 75 95 37 76.1% 84.9% 87.2% 90.5% 92.5% STATEWIDE RESULTS FOR EACH QUESTION IN DOMAIN (RBHA ONLY) General Satisfaction: Q1 Q2 Q3 Denominator 1,788 1,754 1,731 Numerator 1,537 1,449 1,479 Positive Response Percentage 86.0% 82.6% 85.4% Service Access Q4 Q5 Q6 Q7 Q8 Q9 1,738 1,760 1,723 1,750 1,755 1,719 1,433 1,454 1,291 1,508 1,445 1,243 82.5% 82.6% 74.9% 86.2% 82.3% 72.3% Participation in Treatment Planning Q11 Q17 1,756 1,724 1,546 1,397 88.0% 81.0% Service Quality & Appropriateness Q10 Q12 Q13 Q14 Q15 Q16 Q18 Q19 Q20 1,716 1,733 1,752 1,730 1,719 1,735 1,686 1,724 1,694 1,442 1,425 1,557 1,493 1,361 1,557 1,446 1,432 1,406 84.0% 82.2% 88.9% 86.3% 79.2% 89.7% 85.8% 83.1% 83.0% Outcomes Q21 Q22 Q23 Q24 Q25 Q26 Q27 Q28 1,747 1,730 1,736 1,702 1,718 1,384 1,643 1,722 1,353 1,334 1,258 1,254 1,142 847 1,159 1,088 77.4% 77.1% 72.5% 73.7% 66.5% 61.2% 70.5% 63.2% Improved Functioning Q28 Q29 Q30 Q31 Q32 1,722 1,716 1,710 1,736 1,710 1,088 1,251 1,276 1,178 1,185 63.2% 72.9% 74.6% 67.9% 69.3% Social Connectedness 44 2012 Consumer Survey Report Q33 Q34 Q35 Q36 45 1,712 1,750 1,712 1,708 1,267 1,335 1,096 1,336 74.0% 76.3% 64.0% 78.2% 2012 Consumer Survey Report 2012 MHSIP Consumer Survey Numbers Used in Calculation of Performance YOUTH SERVICES SURVEY FOR FAMILIES RESULTS BY T/RBHA & MHSIP DOMAIN Domain: General Satisfaction T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Gila River Navajo Nation Pascua Yaqui White Mountain Apache Denominator 373 141 237 295 201 267 1,505 22 16 61 4 Numerator 317 126 208 241 168 213 1,235 19 15 57 4 Positive Response Percentage 85.0% 89.4% 87.8% 81.7% 83.6% 79.8% 82.1% 86.4% 93.8% 93.4% 100.0% Denominator 366 138 235 296 194 261 1,469 22 16 61 4 Numerator 328 128 218 273 158 226 1,267 21 14 56 4 Positive Response Percentage 89.6% 92.8% 92.8% 92.2% 81.4% 86.6% 86.2% 95.5% 87.5% 91.8% 100.0% Denominator 372 140 237 293 197 267 1,495 22 16 59 4 Numerator 347 130 228 269 176 247 1,373 20 14 54 4 Positive Response Percentage 93.3% 92.9% 96.2% 91.8% 89.3% 92.5% 91.8% 90.9% 87.5% 91.5% 100.0% Domain: Service Access T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Gila River Navajo Nation Pascua Yaqui White Mountain Apache Domain: Participation in Treatment Planning T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Gila River Navajo Nation Pascua Yaqui White Mountain Apache 46 2012 Consumer Survey Report Domain: Cultural Sensitivity T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Gila River Navajo Nation Pascua Yaqui Whtie Mountain Apache Denominator 359 139 232 291 182 253 1,417 22 16 60 4 Numerator 353 135 224 278 166 246 1,356 22 15 58 4 Positive Response Percentage 98.3% 97.1% 96.6% 95.5% 91.2% 97.2% 95.7% 100.0% 93.8% 96.7% 100.0% Denominator 369 140 237 296 200 269 1,506 22 16 60 4 Numerator 239 105 168 186 124 160 929 15 15 56 4 Positive Response Percentage 64.8% 75.0% 70.9% 62.8% 62.0% 59.5% 61.7% 68.2% 93.8% 93.3% 100.0% Denominator 371 140 237 296 200 271 1,515 22 16 60 4 Numerator 253 106 175 199 132 170 1,035 15 15 56 4 Positive Response Percentage 68.2% 75.7% 73.8% 67.2% 66.0% 62.7% 68.3% 68.2% 93.8% 93.3% 100.0% Denominator 369 139 235 293 Numerator 338 130 214 258 Positive Response Percentage 91.6% 93.5% 91.1% 88.1% Domain: Outcomes T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Gila River Navajo Nation Pascua Yaqui Whtie Mountain Apache Domain: Improved Functioning T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Gila River Navajo Nation Pascua Yaqui White Mtn Domain: Social Connectedness T/RBHA GSA 1 - NARBHA GSA 2 - Cenpatico 2 GSA 3 - Cenpatico 3 GSA 4 - Cenpatico 4 47 2012 Consumer Survey Report GSA 5 - CPSA GSA 6 - Magellan Statewide RBHA Gila River Navajo Nation Pascua Yaqui White Mtn 198 260 1,476 22 16 61 4 170 219 1,273 21 15 58 4 85.9% 84.2% 86.2% 95.5% 93.8% 95.1% 100.0% Numerator 1,278 1,170 1,095 1,217 1,170 1,104 Positive Response Percentage 85.1% 78.7% 77.0% 81.9% 78.6% 74.1% 1,482 1,498 1,224 1,236 82.6% 82.5% 1,462 1,483 1,481 1,292 1,345 1,385 88.4% 90.7% 93.5% Cultural Sensitivity Q12 Q13 Q14 Q15 1,513 1,397 1,496 1,358 1,415 1,275 1,421 1,230 93.5% 91.3% 95.0% 90.6% Outcomes Q16 Q17 Q18 Q19 Q20 Q21 Q22 1,493 1,486 1,480 1,474 1,494 1,474 1,482 981 955 987 946 879 861 927 65.7% 64.3% 66.7% 64.2% 58.8% 58.4% 62.6% Improved Functioning Q16 Q17 Q18 Q19 Q20 Q22 1,493 1,486 1,480 1,474 1,494 1,482 981 955 987 946 879 927 65.7% 64.3% 66.7% 64.2% 58.8% 62.6% Social Connectedness Q23 Q24 Q25 Q26 1,470 1,471 1,476 1,446 1,252 1,298 1,163 1,209 85.2% 88.2% 78.8% 83.6% STATEWIDE RESULTS FOR EACH QUESTION IN DOMAIN General Satisfaction: Denominator Q1 1,501 Q4 1,487 Q5 1,423 Q7 1,486 Q10 1,489 Q11 1,490 Service Access Q8 Q9 Participation in Treatment Planning Q2 Q3 Q6 48 2012 Consumer Survey Report ATTACHMENT-D 49 2012 Consumer Survey Report 2012 Adult Demographics 2012 Adult Consumer Survey, Percent of Positive Response by Domain and Subgroup Subgroup General Satisfaction Service Access Service Quality and Appropriateness Participation in Treatment Planning Outcomes Improved Functioning Social Connectedness N % N % N % N % N % N % N % 630 879 88.1% 83.7% 616 841 86.5% 80.9% 622 881 88.7% 85.5% 605 899 89.5% 90.4% 554 697 82.2% 68.1% 500 660 73.9% 65.4% 539 762 78.0% 75.3% 18-21 22-30 31-45 46-65 66-75 76+ 83 230 530 614 42 8 87.4% 83.3% 81.9% 88.7% 91.3% 100% 83 224 506 584 43 8 92.2% 82.7% 77.3% 86.1% 95.6% 100% 80 219 525 623 40 8 95.2% 82.6% 81.1% 92.0% 90.9% 100% 74 221 560 602 39 8 91.4% 86.0% 88.2% 93.2% 88.6% 100% 77 198 450 490 32 7 91.7% 74.2% 70.2% 74.2% 72.7% 100% 63 177 425 453 30 8 80.8% 70.5% 66.3% 68.3% 71.4% 100% 74 193 475 507 37 8 85.1% 74.5% 74.1% 76.2% 82.2% 100% Race White only African American only Asian only Am Indian/Al Native only Nat Hawaiian/Pacific Islander only Multiple Race Ethnicity Hispanic or Latino Not Hispanic or Latino Length of Services 0-6 months 7-11 months 1-2 years 3-5 years 5 years + Program SMI Non-SMI 1092 100 9 86.6% 82.0% 56.3% 1064 95 15 84.6% 79.8% 100% 1110 94 8 89.5% 81.0% 50.0% 1098 97 13 91.9% 86.6% 81.3% 923 66 13 75.2% 57.4% 81.3% 862 58 11 70.8% 51.8% 68.8% 940 72 14 76.6% 60.0% 100% 33 82.5% 33 86.8% 29 78.4% 30 81.1% 29 80.6% 29 82.9% 32 80% 14 27 93.3% 73.0% 15 24 100% 64.9% 13 28 86.7% 75.7% 15 31 100% 86.1% 11 26 73.3% 74.3% 11 25 73.3% 67.6% 10 27 66.7% 79.4% 405 951 88.8% 84.2% 375 922 83.0% 81.5% 389 972 87.6% 86.6% 379 983 89.4% 90.1% 338 785 78.6% 71.2% 304 747 70.7% 68.0% 365 813 83.7% 73.9% 34 37 146 207 1053 91.9% 88.1% 86.4% 87.0% 84.7% 36 35 146 205 1005 97.3% 83.3% 84.9% 86.5% 81.6% 32 38 146 217 1035 86.5% 88.4% 89.6% 90.0% 85.3% 34 38 144 212 1053 97.1% 92.7% 88.3% 92.2% 89.5% 34 35 124 180 852 91.9% 85.4% 74.7% 78.6% 71.4% 32 31 122 162 788 84.2% 77.5% 73.5% 71.7% 66.3% 33 34 137 189 881 86.8% 82.9% 80.6% 82.5% 73.6% 841 512 84.1% 85.3% 798 510 80.7% 85.0% 841 512 84.9% 88.9% 849 506 88.9% 90.2% 687 438 70.5% 77.1% 637 408 66.3% 77.2% 688 482 72.3% 81.4% Gender Male Female Age Group 50 2012 Consumer Survey Report ATTACHMENT-E 51 2012 Consumer Survey Report 2012 Adult Line Item 2012 Adult Consumer Survey, Statewide Percent of Positive Response by Line Item (Line specific numbers are based on actual valid survey returns. Domain percentages are based on weighted scores.) Survey Item General Satisfaction: 1. I like the services that I received here. 2. If I had other choices, I would still get services from this agency. 3. I would recommend this agency to a friend or family member. Service Access: 4. The location of services was convenient (parking, public transportation, distance, etc.) 5 Staff were willing to see me as often as I felt it was necessary. 6. Staff returned my call in 24 hours. 7. Services were available at times that were good for me. 8. I was able to get all the services I thought I needed. 9. I was able to see a psychiatrist when I wanted to. Participation in Treatment Planning 11. I felt comfortable asking questions about my treatment and medication. 17. I, not staff, decided my treatment goals. Service Quality and Appropriateness 10. Staff here believe that I can grow, change and recover. 12. I feel free to complain. 13. I was given information about my rights. 14. Staff encouraged me to take responsibility for how I live my life. 15. Staff helped me to understand what side effects to watch out for. 16 Staff respected my wishes about who is and who is not to be given information about my treatment.. 18. Staff were sensitive to my cultural background (For example: values, traditions, beliefs, race, language, etc.) 19. Staff helped me obtain the information I needed so that I could take charge of managing my illness. 20. I was encouraged to use consumer-run programs (support groups, drop-in centers, crisis phone line, etc.) Outcomes 21. I deal more effectively with daily problems. 22. I am better able to control my life. 23. I am better able to deal with crisis. 24 I am getting along better with my family. 25. I do better in social situations. 26. I do better in school and/or work 27. My housing situation has improved 28. My symptoms are not bothering me as much. 52 Number Percent 1,529 1,537 1,449 1,479 1,474 85.3% 86.0% 82.6% 85.4% 83.1% 1,433 1,454 1,291 1,508 1,445 1,243 1,524 1,546 1,397 1,517 1,442 1,425 1,557 1,493 1,361 82.5% 82.6% 74.9% 86.2% 82.3% 72.3% 90.0% 88.0% 81.0% 86.6% 84.0% 82.2% 88.9% 86.3% 79.2% 1,557 88.9% 1,446 85.8% 1,432 83.1% 1,406 1,273 1,353 1,334 1,258 1,254 1,142 847 1,159 1,088 83.0% 73.7% 77.4% 77.1% 72.5% 73.7% 66.5% 61.2% 70.5% 63.2% 2012 Consumer Survey Report ATTACHMENT-F 53 2012 Consumer Survey Report 2012 YSS-F Demographics 2012 YSS-F, Percent of Positive Response by Domain and Subgroup General Satisfaction Subgroup Service Access Cultural Competency Participation in Treatment Planning Outcomes Improved Functioning Social Connectedness N % N % N % N % N % N % N % 865 338 81.8% 82.2% 894 341 86.5% 85.7% 958 363 95.5% 95.8% 961 375 91.6% 91.7% 672 232 63.3% 56.9% 703 252 66.2% 61.3% 917 327 88.2% 81.5% 3 164 1067 100% 85.0% 81.6% 3 173 1091 100% 89.6% 85.7% 3 181 1172 100% 95.8% 95.7% 3 174 1196 100% 90.6% 92.0% 3 119 808 100% 60.7% 61.8% 3 127 856 100% 64.8% 65.2% 3 170 1100 100% 88.1% 85.9% 822 77 2 44 81.8% 78.6% 100% 80.0% 854 79 2 50 86.5% 80.6% 100% 90.9% 909 90 2 45 96.3% 96.8% 100% 90.0% 916 89 2 50 91.6% 90.8% 100% 90.9% 616 53 0 39 61.4% 52.5% N/A 70.9% 653 53 0 39 64.8% 52.5% N/A 72.2% 838 84 2 52 84.9% 87.5% 100% 96.3% 3 59 100% 80.8% 3 64 100% 95.5% 3 61 100% 88.4% 3 67 100% 93.1% 2 50 66.7% 71.4% 2 51 66.7% 73.9% 1 57 50.0% 81.4% 473 689 84.0% 80.5% 443 717 88.2% 85.3% 493 748 97.4% 95.2% 466 792 91.2% 92.5% 340 496 64.5% 58.2% 365 522 69.1% 61.1% 442 715 87.9% 84.9% 48 84 180 213 624 88.9% 94.4% 84.9% 83.2% 78.4% 51 72 188 223 652 92.7% 87.8% 90.0% 87.1% 83.7% 57 84 201 230 693 100% 96.6% 96.6% 95.8% 95.2% 44 70 201 243 726 81.5% 83.3% 93.5% 93.1% 91.8% 23 73 133 172 461 42.6% 81.1% 61.3% 66.2% 58.0% 29 75 135 175 499 50.9% 84.3% 61.9% 67.0% 82.7% 37 84 173 233 667 72.5% 97.7% 82.8% 91.7% 84.9% 857 264 84.3% 73.9% 903 260 89.8% 77.2% 951 278 96.6% 90.8% 943 307 93.4% 86.5% 635 212 62.3% 59.4% 669 229 65.4% 64.0% 870 295 87.7% 82.6% Gender Male Female Age Group 0-4 5-12 13-17 Race White only African American only Asian only Am Indian/Al Native only Nat Hawaiian/Pacific Islander only Multiple Race Ethnicity Hispanic or Latino Not Hispanic or Latino Length of Services 0-6 months 7-11 months 1-2 years 3-5 years 5 years + CFT Yes No 54 2012 Consumer Survey Report ATTACHMENT-G 55 2012 Consumer Survey Report 2012 YSS-F Line Item 2012 YSSF, Statewide Percent of Positive Response by Line Item (Line specific numbers are based on actual valid survey returns. Domain percentages are based on weighted scores.) Survey Item Number Percent General Satisfaction: 1. Overall, I am satisfied with the services my child received. 4. The people helping my child stuck with us no matter what. 5. I felt my child had someone to talk to when he/she was troubled. 7. The services my child and/or family received were right for us. 10. My family got the help we wanted for my child. 11. My family got as much help as we needed for my child. Service Access 8. The location of services was convenient for us. 9. Services were available at times that were convenient for us. Participation in Treatment Planning 2. I helped to choose my child‟s services. 3. I helped to choose my child‟s treatment goals. 6. I participated in my child‟s treatment. Cultural Sensitivity 12 Staff treated me with respect. 13. Staff respected my family‟s religious/spiritual beliefs. 14. Staff spoke with me in a way that I understood. 15. Staff were sensitive to my cultural/ethnic background. Outcomes 16 My child is better at handling daily life. 17. My child gets along better with family members. 18. My child gets along better with friends and other people. 19. My child is doing better in school and/or work. 20. My child is better able to cope when things go wrong. 21. I am satisfied with our family life right now. 22. My child is better able to do things he or she wants to do. Improved Functioning 16 My child is better at handling daily life. 17. My child gets along better with family members. 18. My child gets along better with friends and other people. 19. My child is doing better in school and/or work. 20. My child is better able to cope when things go wrong. 22. My child is better able to do things he or she wants to do. Social Connectedness 23. I know people who will listen and understand me when I need to talk. 24. I have people that I am comfortable talking with about my child‟s problems. 25. In a crisis, I would have the support I need from family or friends. 26. I have people with whom I can do enjoyable things. 1,235 1,278 1,170 1,095 1,217 1,170 1,104 1,267 1,224 1,236 1,373 1,292 1,345 1,385 1,356 1,415 1,275 1,421 1,230 929 981 955 987 946 879 861 927 986 981 955 987 946 879 927 1,273 1,252 1,298 1,163 1,209 82.1% 85.1% 78.7% 77.0% 81.9% 78.6% 74.1% 86.2% 82.6% 82.5% 91.8% 88.4% 90.7% 93.5% 95.7% 93.5% 91.3% 95.0% 90.6% 61.7% 65.7% 64.3% 66.7% 64.2% 58.8% 58.4% 62.6% 65.2% 65.7% 64.3% 66.7% 64.2% 58.4% 62.6% 86.2% 85.2% 88.2% 78.8% 83.6% 56 2012 Consumer Survey Report ATTACHMENT-H 57 2012 Consumer Survey Report List of Acronyms 2012 Consumer Survey Report Acronyms Description ADHS/DBHS ASOC CBHS CFT CPSA CSOC CSOCPR CSP CSR GMH GSA MHSIP MMWIA NARBHA NASMHPD NOMs NRI PIP QM RBHA RSS SA SAMSHA SMI TBHA WSDSG YSS-F Arizona Department of Health Services/Division of Behavioral Health Services Adult System of Care Cenpatico Behavioral Health Services Child and Family Team Community Partnership of Southern Arizona Children‟s System of Care Child System of Care Practice Review Comprehensive Service Provider Consumer Survey Report General Mental Health Geographical Service Area Mental Health Statistics Improvement Program Meet Me Where I Am Northern Arizona Regional Behavioral Health Authority National Association of State Mental Health Program Directors National Outcomes Measures National Research Institute Performance Improvement Plan Quality Management Regional Behavioral Health Authority Recovery Support Specialist Substance Abuse Substance Abuse and Mental Health Services Administration Serious Mental Illness Tribal Behavioral Health Authority Western States Decision Support Group Youth Services Survey for Families 58 2012 Consumer Survey Report APPENDIX-1 (See attached) Year 2012 Adult Consumer Survey (English and Spanish) 59 2012 Consumer Survey Report THIS SECTION MUST BE COMPLETED BY T/RBHA OR PROVIDER! Name of Service Agency: ____________________________________________________________________ T/RBHA NAME: _________________________ SMI  Program/Fund Source: Client’s Entitlement Status: Survey completed at: Facility ID: ______________ Non-SMI (GMH or SA)  TXIX  TXXI  Survey ID: ________________________ Home  Clinic  By Phone  Client enrolled in DDD: Yes _____ No _____ YEAR 2012 ADULT CONSUMER SURVEY Please help us improve our program by completing this survey about the services you have received in the last six months. We are interested in your honest opinion. All responses will be treated as confidential. Any personal information will be excluded in the presentation of the survey results. Your current and/or future services will not be affected if you decide not to participate in this survey. If you have already taken this survey during the months of April or May 2012, you do not need to complete it again. After you have completed the survey, please fold and drop it in the survey box before you leave the office today. Thank you. Use Pen or Pencil Please fill in the bubbles completely with your answers to the following questions: Information about the Person Receiving Services: Age: Sex:  Male  Female Ethnicity:  Hispanic or Latino  Not Hispanic or Latino Please check all applicable race categories: Race:  White  Black/African American  Native Hawaiian/Pacific Islander  Asian  American Indian/Alaska Native How long have you been receiving mental health and/or substance abuse services? (from any provider)  0 - 6 months  7 - 11 months  1 - 2 years  3 - 5 years  more than 5 years About the Person Completing This Survey: I am the person directly receiving services.  Yes  No If not, please check your relation to the person who is directly receiving services:  Parent/Guardian  Friend  Relative (Uncle, Aunt, Cousin, Grandparent, etc.) Please continue to answer questions on the next page. 60  Other Strongly Agree Agree I am Neutral Disagree Strongly Disagree Not Applicable 2012 Consumer Survey Report PLEASE MARK YOUR ANSWERS BY FILLING IN THE BUBBLES COMPLETELY 1. I like the services that I received here.       2. If I had other choices, I would still get services from this agency.       3. I would recommend this agency to a friend or family member. 4. The location of services was convenient (parking, public transportation, distance, etc.) 5. Staff were willing to see me as often as I felt it was necessary.                   6. Staff returned my call in 24 hours.       7. Services were available at times that were good for me.       8. I was able to get all the services I thought I needed.       9. I was able to see a psychiatrist when I wanted to.       10. Staff here believe that I can grow, change and recover.       11. I felt comfortable asking questions about my treatment and medication.       12. I feel free to complain.       13. I was given information about my rights.       14. Staff encouraged me to take responsibility for how I live my life.       15. Staff helped me to understand what side effects I should watch out for. 16. Staff respected my wishes about who is and who is not to be given information about my treatment. 17. I, not staff, decided my treatment goals. 18. Staff were sensitive to my cultural background. (For example: values, traditions, beliefs, race, language, etc.) 19. Staff helped me obtain the information I needed so that I could take charge of managing my illness. 20. I was encouraged to use consumer-run programs (support groups, drop-in centers, crisis phone line, etc.)                                     21. I deal more effectively with daily problems.       22. I am better able to control my life.       23. I am better able to deal with crisis.       24. I am getting along better with my family.       25. I do better in social situations.       26. I do better in school and/or work.       27. My housing situation has improved.       28. My symptoms are not bothering me as much.       29. I do things that are more meaningful to me.       30. I am better able to take care of my needs.       31. I am better able to handle things when they go wrong.       32. I am better able to do things that I want to do.       In order to provide the best possible behavioral health services, we need to know what you think about the services you received DURING THE LAST 6 MONTHS, the people who provided it, and the results. As a direct result of the services I received: Please continue to answer questions on the next page. 61 2012 Consumer Survey Report Strongly Agree Agree I am Neutral Disagree Strongly Disagree Not Applicable PLEASE MARK YOUR ANSWERS BY FILLING IN THE BUBBLES COMPLETELY 33. I am happy with the friendships I have.       34. I have people with whom I can do enjoyable things.       35. I feel I belong in my community.       36. In a crisis, I would have the support I need from family or friends.                         For questions 33-36 please answer for relationships with persons other than your mental health provider(s) State-added Questions: 37. In creating my service plan my cultural preferences were included. (For example: values, traditions, beliefs, race, language, etc.) 38. Services were provided in a language I understood. 39. In creating my service plan our tribal customs and beliefs were included. (For example: being asked to participate in traditional healing practices.) If you do not participate in tribal customs, please mark Not Applicable. Please answer the following questions to let us know how you are doing. 40. How long have you received mental health services from this provider?  Less than a year (less than 12 months) (Continue to Question 41)  1 year or more (at least 12 months) (Skip to Question 44) If you answered “Less than a year (less than 12 months)”, please complete questions 41 - 43. 41. Were you arrested since you began to receive mental health services? 42. Were you arrested during the 12 months prior to that? 43. Since you began to receive mental health services, have your encounters with police…  Yes  No  Yes  No  been reduced (for example, I have not been arrested, hassled by police, taken by police to a shelter or crisis program)  stayed the same  increased  not applicable (I had no police encounters this year or last year) If you answered “1 year or more (at least 12 months)”, please complete questions 44 - 46. 44. Were you arrested during the last 12 months?  Yes 45. Were you arrested during the 12 months prior to that? 46. Over the last year, have your encounters with police…  No  Yes  No  been reduced (for example, I have not been arrested, hassled by police, taken by police to a shelter or crisis program)  stayed the same  increased  not applicable (I had no police encounters this year or last year) Please continue to answer questions on the next page. 62 2012 Consumer Survey Report Please feel free to use the space provided below to comment on any of your answers. Also, if there are areas which were not covered by this questionnaire which you feel should have been, please write them in the comments section. Thank you for your time and cooperation in completing this questionnaire. What have been some of the most helpful things about the services you received over the last 6 months? ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ What would improve the services that you receive here? ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Please list any other comments you may want to share: ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Thank you for completing this questionnaire. 63 2012 Consumer Survey Report ¡¡ESTA SECCIÓN DEBE SER COMPLETADA POR LA RBHA O EL PROVEEDOR!! Nombre de Agencia de Servicio ____________________________________________________ NOMBRE de LA RBHA: ___________________________ SMI  Fuente de Programa/Fondo: El Estado de Elegibilidad del Cliente: Encuesta tomada en: Casa  ID de la agencia o proveedor: ___________ No - SMI (GMH o SA)  TXIX  TXXI  ID de la encuesta: Clínica  Por teléfono  _________________ Cliente inscrito en DDD: Si_____ No_____ ENCUESTA DE SERVICIOS PARA ADULTOS QUE RECIBIERON SERVICIOS DURANTE EL AÑO 2012 Por favor ayúdenos a mejorar nuestro programa completando ésta revisión sobre los servicios que usted ha recibido en los últimos seis meses. Estamos interesados en su opinión honesta. Todas las respuestas serán tratadas como confidenciales. Cualquier información personal será excluida en la presentación de los resultados ésta encuesta. Sus servicios actuales y/o futuros no se verán afectados si usted decide no participar en ésta encuesta. Si usted ha tomado ya ésta encuesta en los meses de abril o mayo de 2012, no tiene que completarla otra vez. Después de que usted haya finalizado, por favor doble la hoja y deposítela en la caja de encuestas, antes de usted salga de la oficina hoy. Gracias. Use pluma o lápiz Por favor rellene las burbujas completamente con sus respuestas a las siguientes preguntas: Información acerca de la persona que recibe los servicios: Edad: _______  Masculino Sexo:  Femenino  Hispano o Latino Pertenencia étnica:  No Hispano o Latino Por favor compruebe todas las categorías de raza aplicables Raza:  Blanco  Negro/Africano Americano  Nativo Americano / Nativo de Alaska  Asiático  Nativo de Hawai/Isleño del Pacífico ¿Por cuánto tiempo ha estado recibiendo servicios de salud mental y/o de abuso de sustancias? (de cualquier proveedor )  0 - 6 meses  7 - 11 meses  1 - 2 años  3 - 5 años  más de 5 años Sobre la persona que completa ésta encuesta: Soy la persona que directamente recibe servicios:  Sí  No Si no, por favor marque la relación con la persona que recibe directamente servicios:  Padre/Guardián  Amigo  Pariente (Tío, Tía, Primo, Abuelo, etc.)  Otro Por favor siga contestando preguntas en la siguiente página. 64 Muy de acuerdo De acuerdo Neutro En Desacuerdo Muy en desacuerdo No Aplica 2012 Consumer Survey Report POR FAVOR MARQUE SUS RESPUESTAS RELLENANDO LAS BURBUJAS COMPLETAMENTE 1. Me gustaron los servicios que recibí aquí. 2. Si yo tuviera otras opciones, yo todavía preferiría los servicios de esta agencia. 3. Yo recomendaría ésta agencia a un miembro de la familia o un amigo. 4. La ubicación de los servicios fue conveniente (estacionamiento, transporte público, distancia, etc.) 5. El personal quiso verme tan a menudo como sentí que era necesario.                               6. El personal devolvió mi llamada en 24 horas. 7. Los servicios estaban disponibles a las horas que eran convenientes para mí. 8. Recibí los servicios que pensé que necesitaba.                   9. Pude ver a un Psiquiatra cuando así lo solicité.       10. El personal aquí cree que puedo crecer, cambiar y recuperarme. 11. Me sentí cómodo haciendo preguntas acerca de mi tratamiento y medicación. 12. Me siento libre de presentar mis inquietudes sobre los servicios.                   13. Me dieron la información sobre mis derechos. 14. El personal me animó a tomar la responsabilidad de como vivo mi vida. 15. El personal me ayudó a entender acerca de los efectos secundarios sobre los que debo estar preparado. 16. El personal respetó mis deseos sobre a quién sí y a quien no deben dar información sobre mi tratamiento. 17. Yo, y no el personal, decidí las metas de mi tratamiento.                               18. El personal fue respetuoso de mis raíces culturales/étnicas. (Por ejemplo: mis valores, tradiciones, creencias, raza, lenguaje, etc.).       19. El personal me ayudó a obtener la información que necesité de modo que yo pudiera hacerme cargo de manejar mi enfermedad. 20. Fui animado a usar programas manejados por consumidores (grupos de apoyo, centros de ayuda informal, línea telefónica de crisis, etc.)             Como un resultado directo de los servicios recibí: 21. Manejo de forma más eficaz los problemas diarios.       22. Soy más capaz de controlar mi vida.       23. Soy más capaz de lidiar con las crisis.       24. Me llevo mejor con los miembros de mi familia.       25. Me desenvuelvo mejor en situaciones sociales.       26. Tengo mejor desempeño en la escuela y/o trabajo.       27. Mi situación de vivienda ha mejorado.       28. Los síntomas no me molestan tanto como antes.       29. Hago cosas que son más significativas para mí.       30. Soy más capaz de ocuparme de mis necesidades.       31. Soy más capaz de manejar las cosas o situaciones cuando no van bien.       32. Soy más capaz de hacer cosas que quiero hacer.       A fin de proporcionar un mejor servicio en los cuidados de salud mental y de abuso de sustancias, tenemos que saber lo que usted piensa sobre los servicios que recibió DURANTE los 6 MESES PASADOS, la gente que lo proporcionó, y los resultados. Por favor siga contestando preguntas en la siguiente página. 65 Muy de acuerdo De acuerdo Neutro En Desacuerdo Muy en desacuerdo No Aplica 2012 Consumer Survey Report POR FAVOR MARQUE SUS RESPUESTAS RELLENANDO LAS BURBUJAS COMPLETAMENTE 33. Soy feliz con las amistades que tengo.       34. Tengo a personas con quienes puedo hacer cosas agradables.       35. Siento que pertenezco a mi comunidad.       36. En una crisis, yo tendría el apoyo que necesito de familia o amigos.       Preguntas adicionales del estado: 37. En la creación de mi plan de servicios, mis preferencias culturales fueron incluidas. (Por ejemplo; mis valores, tradiciones, creencias, raza, lenguaje, etc.). 38. Los servicios me fueron proporcionados en un lenguaje que entendí.             39. En la creación de mi plan de servicios las tradiciones y creencias de mi tribu fueron incluidas (Por ejemplo: me preguntaron si quería participar en sesiones de sanación tradicional). Si usted no participa de las tradiciones tribales, por favor marque la opción "No aplica".       Para las preguntas 33-36 por favor responda basado en las relaciones con personas diferentes de su proveedor (es) de salud mental. Por favor conteste las siguientes preguntas para hacernos saber cómo se encuentra. 40. ¿Durante cuánto tiempo ha recibido usted servicios de  Menos de un año (menos de 12 meses) salud mental de éste proveedor? (Continué con la pregunta 41)  1 año o más (al menos 12 meses) (Vaya a la pregunta 44) Si su respuesta es “menos de un año (menos de 12 meses)”, por favor complete las preguntas 41-43. 41. ¿Ha sido usted arrestado desde que comenzó a recibir  Sí  No servicios de salud mental? 42. ¿Ha sido usted arrestado durante los 12 meses  Sí  No anteriores a esto? 43. Desde que usted comenzó a recibir servicios de salud  han disminuido (por ejemplo, no he sido mental, ha tenido incidentes con la policía… arrestado, molestado por la policía, enviado por la policía a un refugio o programa de crisis)  han sido igual  han aumentado  no aplicable (yo no he tenido ningún incidente con la policía durante este año o el año pasado) Si su respuesta es “1 año o más (al menos 12 meses)”, por favor complete las preguntas 44 - 46. 44. ¿Ha sido arrestado durante los 12 meses pasados?  Sí 45. ¿Ha sido arrestado durante los 12 meses anteriores a esto? 46. Durante el año pasado, sus incidentes con la policía …  Sí  No  No  han disminuido (por ejemplo, no he sido arrestado, molestado por policía, enviado por la policía a un refugio o programa de crisis)  han sido igual  han aumentado  no aplicable (yo no he tenido ningún encuentro con la policía durante este año o el año pasado) Por favor siga contestando preguntas en la siguiente página. 66 2012 Consumer Survey Report Por favor siéntase libre de usar el espacio proporcionado abajo para comentar sobre cualquiera de sus respuestas. También, si hay áreas que no fueron cubiertas por este cuestionario que usted siente que deberían haber sido incluidas, por favor escríbalas en la sección de comentarios. Gracias por su tiempo y cooperación en completar éste cuestionario. ¿Cuáles han sido algunas cosas más provechosas sobre los servicios que usted recibió durante los 6 meses pasados? ¿Qué mejoraría los servicios qué usted recibe aquí? Por favor escriba cualquier otro comentario que usted quiera compartir: Gracias por completar este cuestionario. 67 2012 Consumer Survey Report APPENDIX-2 (See attached) Year 2012 Youth Consumer Survey for Families (English and Spanish) 68 2012 Consumer Survey Report THIS SECTION MUST BE COMPLETED BY T/RBHA OR PROVIDER! Name of Service Agency: ____________________________________________________________________ T/RBHA NAME: ________________________ Client’s Entitlement Status: TXIX  Facility ID:_______________ TXXI  Survey ID: ____________________________ Survey completed at: Home  Clinic  By Phone  Client enrolled in DDD: Yes ______ No ______ YEAR 2012 YOUTH SERVICES SURVEY FOR FAMILIES Please help us improve our program by completing this survey about the services you have received in the last six months. We are interested in your honest opinion. All responses will be treated as confidential. Any personal information will be excluded in the presentation of the survey results. Your child and family’s current and/or future services will not be affected if you decide not to participate in this survey. If you have already taken this survey in the months of April or May 2012, then you do not need to complete it again. After you have completed the survey, please fold and drop it in the survey box before you leave the office today. Thank you. Use Pen or Pencil Please fill in the bubbles completely with your answers to the following questions: Information about the Person Receiving Services: Child’s Age: Child’s Sex:  Male Child’s Ethnicity:  Hispanic or Latino  Female  Not Hispanic or Latino Please check all applicable race categories: Child’s Race:  White  Black/African American  Native Hawaiian/Pacific Islander  Asian  American Indian/Alaska Native How long has your child been receiving mental health and/or substance abuse services? (from this provider)  0 - 6 months  7 - 11 months  1 - 2 years Please check your relationship with the child: Does your family have a Child and Family Team?  3 - 5 years  more than 5 years  Parent/Guardian  Friend  Relative (Uncle, Aunt, Cousin, Grandparent, etc.)  Other  Yes  No Please continue to answer questions on the next page. PLEASE MARK YOUR ANSWERS BY FILLING IN THE BUBBLES COMPLETELY 69 Strongly Agree Agree I am Neutral Disagree Strongly Disagree Not Applicable 2012 Consumer Survey Report 1. Overall, I am satisfied with the services my child received.       2. I helped to choose my child’s services.       3. I helped to choose my child’s treatment goals.       4. The people helping my child stuck with us no matter what.       5. I felt my child had someone to talk to when he/she was troubled.       6 I participated in my child’s treatment.       7. The services my child and/or family received were right for us.       8. The location of services was convenient for us.       9. Services were available at times that were convenient for us.       10. My family got the help we wanted for my child.       11. My family got as much help as we needed for my child.       12. Staff treated me with respect.       13. Staff respected my family’s religious/spiritual beliefs.       14. Staff spoke with me in a way that I understood. 15. Staff were sensitive to my cultural/ethnic background. (For example: values, traditions, beliefs, race, language, etc.)             16. My child is better at handling daily life.       17 My child gets along better with family members.       18. My child gets along better with friends and other people.       19. My child is doing better in school and/or work.       20. My child is better able to cope when things go wrong.       21 I am satisfied with our family life right now.       22. My child is better able to do things he or she wants to do.       Please help our agency make services better by answering some questions about the services your child received OVER THE LAST 6 MONTHS. As a result of the services my child and/or family received: As a result of the services my child and/or family received: please answer for relationships with persons other than your mental health provider(s). 23 I know people who will listen and understand me when I need to talk. 24. I have people that I am comfortable talking with about my child’s problems. 25 In a crisis, I would have the support I need from family or friends.                   26. I have people with whom I can do enjoyable things.       27. What has been the most helpful thing about the services you and your child received over the last 6 months? ________________________________________________________________________________________________ ________________________________________________________________________________________________ 28. What would improve the services here? _____________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Please continue to answer questions on the next page. PLEASE MARK YOUR ANSWERS BY FILLING IN THE BUBBLES COMPLETELY 70 Agree I am Neutral Disagree Strongly Disagree Not Applicable State-added Questions: 29. In creating my child’s service plan our cultural preferences were included. (For example: values, traditions, beliefs, race, language, etc.) 30. Services were provided in a language my child understood. 31. In creating my child’s service plan our tribal customs and beliefs were included. (For example: being asked to participate in traditional healing practices.) If you do not participate in tribal customs, please mark Not Applicable. Strongly Agree 2012 Consumer Survey Report                   Please answer the following questions to let us know how your child is doing. 32. Is your child currently living with you?  Yes  No 33. Has your child lived in any of the following places in the last 6 months? (CHECK ALL THAT APPLY)  With one or both parents  With another family member  Foster home  Therapeutic foster home  Crisis shelter  Homeless shelter  Group home  Residential treatment facility  Hospital  Local jail or detention facility  State correctional facility  Runaway/homeless/on the streets  Other (describe):________________________________________________________________________________ 34. In the last year, did your child see a medical doctor (or nurse) for a health check up or because he/she was sick? (Check one)  Yes, in a clinic or office  Yes, but only in a hospital emergency room  No  Do not remember 35. Is your child on medication for emotional/behavioral problems? 36. If yes, did the doctor or nurse tell you and/or your child what side effects to watch for? 37. Is your child still getting services from this provider? 38. How long did your child receive services from this provider?  Yes  No  Yes  No  Yes  No  Less than 1 month  1-5 Months  6 months to 1 year  More than 1 year (skip to Question 45) 39. Was your child arrested since beginning to receive mental health services? 40. Was your child arrested during the 12 months prior to that? 41. Since your child began to receive mental health services, have their encounters with the police…  Yes  No  Yes  No  been reduced (for example, they have not been arrested, hassled by the police, taken by police to a shelter or crisis program)  stayed the same  increased  not applicable (They had no police encounters this year or last year) 42. Was your child expelled or suspended from school since beginning services? 43. Was your child expelled or suspended from school during the 12 months prior to that?  Yes  No  Yes  No Please continue to answer questions on the next page. 71 2012 Consumer Survey Report PLEASE MARK YOUR ANSWERS BY FILLING IN THE BUBBLES COMPLETELY 44. Since starting to receive services, the number of days my child was in  greater school is…  about the same  less  does not apply (please select why this does not apply)  child did not have a problem with attendance before starting services  child is too young to be in school  child was expelled from school  child is home schooled  child dropped out of school  Other: 45. Was your child arrested during the last 12 months? 46. Was your child arrested during the 12 months prior to that? 47. Over the past year, have your child’s encounters with the police…  Yes  No  Yes  No  been reduced (for example, they have not been arrested, hassled by the police, taken by police to a shelter or crisis program)  stayed the same  increased  not applicable (They had no police encounters this year or last year) 48. Was your child expelled or suspended from school during the last 12 months? 49. Was your child expelled or suspended from school during the 12 months prior to that? 50. Over the last year, the number of days my child was in school is…  Yes  No  Yes  No  greater  about the same  less  does not apply (please select why this does not apply)  child did not have a problem with attendance before starting services  child is too young to be in school  child was expelled from school  child is home schooled  child dropped out of school  Other: Please continue to answer questions on the next page. 72 2012 Consumer Survey Report Please feel free to use the space provided below to comment on any of your answers. Also, if there are areas which were not covered by this questionnaire which you feel should have been, please write them in the comments section. Thank you for your time and cooperation in completing this questionnaire. Please list any other comments you may want to share: ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Thank you for completing this questionnaire. 73 2012 Consumer Survey Report ¡¡ESTA SECCIÓN DEBE SER COMPLETADA POR LA RBHA O EL PROVEEDOR!! Nombre de Agencia de Servicio __________________________________________ NOMBRE de la RBHA: __________________ TXIX  El Estado de Elegibilidad del Cliente: Encuesta tomada en : Casa  ID de agencia o proveedor: _____________ TXXI  Clínica  Por teléfono  ID de la encuesta: ___________________ Cliente inscrito en DDD: Si____ No_____ ENCUESTA PARA FAMILIAS DE JÓVENES QUE RECIBIERON SERVICIOS DURANTE EL AÑO 2012 Por favor ayúdenos a mejorar nuestro programa completando ésta encuesta sobre los servicios que usted ha recibido en los últimos seis meses. Estamos interesados en su opinión honesta. Todas las respuestas serán tratadas como confidenciales. Cualquier información personal será excluida en la presentación de los resultados de ésta encuesta. Los servicios actuales y/o futuros de su hijo(a) o la familia no se verán afectados si usted decide no participar en esta encuesta. Si usted ha tomado ya esta encuesta en los meses de abril o mayo de 2012, no tiene que completarla otra vez. Después de que usted haya finalizado, por favor doble la hoja y deposítela en la caja de encuestas, antes de usted salga de la oficina hoy. Gracias. Use pluma o lápiz Por favor rellene las burbujas completamente con sus respuestas a las preguntas siguientes: Información acerca de la persona que recibe los servicios: La Edad del Niño: El Sexo del Niño:  Masculino La Pertenencia étnica del Niño  Femenino  Hispano o Latino  No Hispano o Latino Por favor compruebe todas las categorías de raza aplicables: La Raza del Niño:  Blanco  Negro/Africano Americano  Asiático  Nativo Americano / Nativo de Alaska  Nativo de Hawai/Isleño del Pacífico ¿Por cuánto tiempo ha estado su hijo recibiendo servicios de salud mental y/o de abuso de sustancias? (De éste proveedor)  0 - 6 meses  7 - 11 meses  1 - 2 años  3 - 5 años  más de 5 años Por favor indique su relación con el niño:  Padre/Guardián  Amigo  Pariente (Tío, Tía, Primo, Abuelo, etc.)  Otro ¿Tiene su familia un Equipo del Niño y la Familia?  Sí  No Por favor siga contestando preguntas en la siguiente página. 74 2012 Consumer Survey Report Muy De acuerdo De acuerdo Neutro En desacuerdo Muy en desacuerdo No Aplica POR FAVOR MARQUE SUS RESPUESTAS RELLENANDO LAS BURBUJAS COMPLETAMENTE 1. En general, estoy satisfecho con los servicios que mi hijo recibió.       2. Ayudé elegir los servicios de mi hijo.       3. Ayudé elegir los objetivos de tratamiento de mi hijo.       4. La gente que ayuda a mi hijo nos apoyó sin falta.       5. Sentí que mi hijo tenía a alguien para dirigirse cuando estaba preocupado.       6. Participé en el tratamiento de mi hijo. 7. Los servicios que mi hijo y/o la familia recibieron fueron los apropiados para nosotros. 8. La ubicación de los servicios fue conveniente para nosotros. 9. Los servicios estuvieron disponibles en momentos en que fue conveniente para nosotros. 10. Mi familia recibió la ayuda que estábamos buscando para mi hijo.                               11. Mi familia recibió tanta ayuda como necesitábamos para mi hijo.       12. El personal me trató con respeto.       13. El personal respetó las creencias religiosas/espirituales de mi familia.       14. El personal habló conmigo de tal forma que entendí. 15. El personal fue respetuoso de mis raíces culturales/étnicas. (Por ejemplo: mis valores, tradiciones, creencias, raza, lenguaje, etc.).             Como resultado de los servicios que mi niño y/o la familia recibieron: 16. Mi hijo maneja de forma más eficaz los problemas diarios.       17. Mi hijo se lleva mejor con los otros miembros de la familia.       18. Mi hijo se lleva mejor con los amigos y otras personas.       19. A mi hijo le va mejor en la escuela y/o el trabajo.       20. Mi hijo está más dispuesto a enfrentar las situaciones difíciles.       21. Estoy satisfecho con nuestra vida familiar actualmente.       22. Mi hijo es más capaz de hacer las cosas que quiere hacer.       Por favor ayude a nuestra agencia a mejorar los servicios, contestando algunas preguntas sobre los servicios que su niño recibido DURANTE LOS ÚLTIMOS 6 MESES. Como resultado de los servicios que mi niño y/o la familia recibieron: por favor responda basado en las relaciones con personas diferentes de su proveedor(es) de salud mental. 23. Conozco gente que escuchará y me entenderá cuando necesito      hablar. 24. Tengo personas con las que me siento cómodo hablando acerca del      problema de mi hijo.      25. En una crisis, yo tendría el apoyo que necesito de mi familia o amigos.      26. Cuento con personas con quienes puedo hacer cosas agradables. 27. ¿Cuál ha sido la cosa más provechosa sobre los servicios usted y su hijo recibieron durante los 6 meses pasados? 28. ¿Qué mejoraría los servicios aquí? Por favor siga contestando preguntas en la siguiente página. 75     2012 Consumer Survey Report 32. ¿Vive actualmente su hijo con usted? 33. ¿Ha vivido su hijo en cualquiera de los siguientes sitios en los últimos 6 meses?  Sí Muy en desacuerdo No Aplica Pregunta adicional del estado: 29. En la creación del plan de servicios de mi hijo, nuestras preferencias   culturales fueron incluidas. (Por ejemplo; mis valores, tradiciones, creencias,  raza, lenguaje, etc.).    30. Los servicios fueron proporcionados en un lenguaje que mi hijo entendiera. 31. En la creación del plan de servicios de mi hijo nuestras tradiciones y creencias tribales fueron incluidas (Por ejemplo: se nos preguntó si    queríamos participar en sesiones de sanación tradicional). Si usted no participa de las tradiciones tribales, por favor marque la opción "No aplica". Por favor conteste las siguientes preguntas, para informarnos acerca de cómo va su hijo. En desacuerdo Neutro De acuerdo Muy De acuerdo POR FAVOR MARQUE SUS RESPUESTAS RELLENANDO LAS BURBUJAS COMPLETAMENTE           No (MARQUE TODAS LAS QUE APLICAN)  Con uno o ambos padres  Con otro miembro de familia  Familia adoptiva terapéutica  Refugio de crisis  Centro de tratamiento  Casa de Grupo  Cárcel local o instalación de detención  Otro (describa)  Instalación correccional 34. ¿Durante el año pasado, visitó su hijo un médico (o enfermera) para un control de salud o porque él/ella estaba enfermo? (Elija una de las opciones)  Familia adoptiva  Refugio para los sin hogar  Hospital  Escapó/o vive en las calles  Sí, en una clínica o oficina  Sí, pero sólo en un cuarto de emergencia de hospital  No  No recuerdo 35. ¿Está su hijo tomando medicamentos para problemas de conducta / emocionales? 36. ¿Si la respuesta es afirmativa, responda si el médico o la enfermera le explicaron con qué clase de efectos secundarios debe estar alerta? 37. ¿Todavía está su hijo recibiendo servicios de éste proveedor? 38. ¿Por cuánto tiempo recibió su hijo servicios de éste proveedor?  Sí  No  Sí  No  Sí  No  Menos de 1 mes  1-5 Meses  6 Meses a 1 año  Más de 1 año (vaya a la pregunta 45) 39. ¿Ha sido su hijo arrestado desde que comenzó a recibir servicios de salud mental? 40. ¿Estuvo arrestado su hijo durante los 12 meses anteriores a ésto? 41. Desde que su hijo comenzó a recibir servicios de salud mental, los incidentes con la policía...  Sí  No  Sí  No  han disminuido (por ejemplo, no ha sido arrestado, molestado por la policía, llevado por la policía a un refugio o programa de crisis)  han sido igual  han aumentado  no aplicable (no tuvo ningún incidente con la policía éste año o el año pasado) 42. ¿Ha sido su hijo expulsado o suspendido de su escuela desde que comenzó a recibir los servicios? 43. ¿Fue su hijo expulsado o suspendido de su escuela durante los 12 meses anteriores a ésto?  Sí  No  Sí  No Por favor siga contestando preguntas en la siguiente página. 76 2012 Consumer Survey Report POR FAVOR MARQUE SUS RESPUESTAS RELLENANDO LAS BURBUJAS COMPLETAMENTE 44. Desde que comenzó a recibir servicios, el número de días que mi hijo estuvo en la escuela fue…  mayor  el mismo  menos  no se aplica (por favor seleccione por qué éste no se aplica)  el niño no tenía un problema con la asistencia antes de los servicios iniciales  el niño es demasiado joven para estar en la escuela  el niño fue expulsado de la escuela  el niño está siendo enseñado en la casa  el niño abandonó la escuela 45. ¿Ha sido su hijo arrestado durante los 12 meses pasados? 46. ¿Estuvo arrestado su hijo durante los 12 meses antes a ésto? 47. Durante el año pasado, los incidentes de su niño con la policía…  Otro  Sí  No  Sí  No  han disminuido (por ejemplo, no ha sido arrestado, molestado por la policía, llevado por la policía a un refugio o programa de crisis)  han sido igual  han aumentado  no aplicable ( no tuvo ningún encuentro con policía éste año o el año pasado) 48. ¿Fue expulsado su niño o suspendido de la escuela durante los 12 meses pasados? 49. ¿Fue expulsado su niño o suspendido de la escuela durante los 12 meses antes de esto? 50. Durante el año pasado, el número de días mi niño fue a la escuela era…  Sí  No  Sí  No  mayor  el mismo  menos  no se aplica (por favor seleccione por qué éste no se aplica)  El niño no tenía un problema con la asistencia antes de servicios iniciales  El niño es demasiado joven para estar en la escuela  El niño fue expulsado de la escuela  El niño está siendo enseñado en la casa  El niño abandonó la escuela  Otro Por favor siga contestando preguntas en la siguiente página. 77 2012 Consumer Survey Report Por favor siéntase libre de usar el espacio proporcionado abajo para comentar sobre cualquiera de sus respuestas. También, si hay áreas que no fueron cubiertas por éste cuestionario que usted siente deberían haber sido incluidas, por favor escríbalas en la sección de comentarios. Gracias por su tiempo y cooperación en completar éste cuestionario. Por favor escriba cualquier otro comentario que usted quiera compartir: Gracias por completar éste cuestionario. 78