2022 Community Report Card
2022
Report Card
| Area |
Objective |
Measure |
Target |
Average |
| Access |
Ensure that individuals have access to all appropriate services in routine, urgent and emergency situations |
Responsiveness to initial request for service. |
0-2 Business Days – For initial referral to scheduled Initial Assessment |
1.52 days |
| Access |
Ensure that individuals have access to all appropriate services in routine, urgent and emergency situations |
Responsiveness to initial request for service. |
0-5 Business Days - Intake to scheduled appointment for Treatment |
5 days |
| Access |
Ensure that individuals have access to all appropriate services in routine, urgent and emergency situations |
Responsiveness to initial request for service. |
0-14 Business Days – From intake to First scheduled MD appointment |
8 Days |
| Access |
Ensure that individuals have access to all appropriate services in routine, urgent and emergency situations |
Responsiveness to initial request for service. % |
Appointment Canceled by Staff is less than 5% |
0.74% |
| Access COVID Impact |
Service provided in natural community settings |
BH Services provided in home, school or community % |
70% |
20% |
| Engagement into Treatment |
Appointments Kept at Initial Assessments |
Show Rate % |
80% |
80% |
| Engagement into Treatment |
Initial Psychiatric Appointments Kept |
Show Rate % |
80% |
92% |
| Substance Use Disorders Child & Adolescent |
Evidence of outpatient substance abuse treatment services & programming available |
Hours Available |
5 hours |
10 hours |
| Substance Use Disorders Child & Adolescent |
Evidence of individuals with co-occurring SUD diagnosis receive group counseling to addresses SUD issues |
% Individuals Receiving Group Services |
80% |
70% |
| Effectiveness |
Improved Community Functioning |
% of clients with no reentry into crisis stabilization units and/or long-term psychiatric facilities. |
70% |
75% |
| Individual Satisfaction |
Satisfaction with services provided |
maintain a total score of 90% customer satisfaction (Agree/Strongly Agree) |
76% |
50-94% |
| Family Satisfaction |
Satisfaction with services provided |
maintain a total score of 90% family satisfaction (Agree/Strongly Agree) |
97% |
84-100% Mode=100 (n=11/24) |
| Stakeholder Satisfaction |
Satisfaction with services provided |
maintain a total score of 90% stakeholder satisfaction |
90% |
91% |
| Risk/Corporate Compliance |
Reduce Risk |
Conformance with HIPPA/Corporate Compliance % |
100% |
100% |
| Risk/Corporate Compliance |
Reduce Risk |
Number Worker Comp Injuries |
1 |
0.025% (n=1/40) |
| Risk/Corporate Compliance |
Reduce Risk |
# avoidable accidents |
0 |
0 |
| Human Resources |
Maintain “0” Staff Grievances |
0 |
0 |
|
| Human Resources |
Train Clinical Staff in Best Practice |
% Staff ESFT Trained (Clinical Director/Consulting withDr Steve Simms, Phd.)) |
100% |
100% |
| Health/Safety |
Reduce Risk/Increase Staff/Customer Safety |
Compliance with scheduled drills % |
100% |
100% |
| External Audits |
Compliance with DBHDDF/DCH Billing Standards |
ASO/CMO Score % |
90% |
81% |
| External Audits |
Compliance with DBHDD Documentation Standards |
ASO Score % |
90% |
94% |
| Peer Review Clinical Documentation |
Compliance with DCH/ DBHDD & DII Standards |
% Compliance |
100% |
90% |