COMMUNITY STRATEGIES: New Hampshire Manchester, NH Comprehensive Program Review July 31, 2015

OVERALL HIGHLIGHTS NH continues to show growth – 6 new clients during this period. The CSNH management team (Leslie Nelson, Tia Tallman, Charles Richwine and Wendy Signer) and our clinician (Sandy Tarlow) continues to be very strong and we work extremely well together. We have 2 Office Coordinators – one in Manchester (Bonnie Addario) and one in Keene (Christine Parsons). This has worked out very well. Both the Manchester Office and Keene Office have been re-organized. Billing for services is now completed in a timely fashion. Even though a key fiscal positon was lost right before budget season, a FY 16 budget was completed, which included growth. With assistance from fiscal all individual contracts have been analyzed and have been renegotiated or in process.

CSNH

Peterborough Community Participation Services Peterborough officially opened their doors on 12/11/14. In the few short months, Peterborough has already developed into, what is considered by all the MDS Case Managers and families, one of the best CPS programs in NH. CSNH started with all new staff and new clients who had never met each other before. As of 5/31/15, the program has four clients. Quickly they built a strong bond. Not only did the individuals make new friends but the DSP’s work together as a team and help each other wherever needed. Peterborough Community Participation Services

Peterborough

INDIVIDUAL HIGHLIGHTS Even though Butch passed away on 4/17/15, his support from the Keene Fire Department was amazing. Patrick T. who is very medically involved is participating in community activities such as playing pool, fishing, dinner, etc. Tina has made amazing strides – living in NH, going out into the community, making new friends. Improved relationship with Home Providers – Wendy has worked hard to mend these relationships and has become very involved. George is now involved in community activities and very involved in activities at the Peterborough Center. He started in December and was living in a nursing home spending most of his day in a geriatric chair. Patrick M. continues to live in Manchester.

CHALLENGES The NH budget Managed Care Open DSP positions in all programs - therefore Managers filling the open shifts The limited applicants in NH due to a very low unemployment rate The geographical locations of the CSNH Programs Small management team giving less resources Managers working too many hours to meet the demands of CSNH Vacant Director of Business Administration position Opening new programs with limited resources Continuing to address certification with limited resources Completing the MMR, Certification summary, etc. in a timely fashion. Meeting the training needs for new and current employees

STAFFING Staff Turnover Rates Staff Retention Rates Staff Training Hours

STAFF TURNOVER RATES The turnover rate for CSNH is 20.5% compared to the overall CRJ turnover rate of 26.4% Last CPR, the CSNH turnover rate 38.2% compared to overall CRJ turnover rate of 29.3% Data obtained from HR Turnover and Retention Reports

STAFF RETENTION RATES The retention rate for CSNH is 75% compared to the overall CRJ retention rate of 70.9% Last CPR, the CSNH retention rate 58.1% compared to overall CRJ retention rate of 68.5% Data obtained from HR Turnover and Retention Reports

STAFF TRAINING HOURS September 2013 – February 2014 E Training Hours MMR Training Hours Total Keene 99 60.75 159.75 Unity House 64 Manchester 42 63 105 Totals 141 187.75 328.75 December 2014 – May 2015 E Training Hours MMR Training Hours Total Keene 85 114 199 Unity House N/A Manchester 28.75 113.75 Totals 312.75 Total of 312.75 training hours; an average of 13.9 hours per staff over six months Last CPR, a total of 328.75 training hours; an average of 8.4 hours per staff/over six months Data obtained from MMRs and HR Reports

CLIENT RELATED Clinical Hours Elopements Restraints New Clients Medication

CLINICAL HOURS September 2013 – February 2014 (old CPR) A total of 30 clinical individual and groups hours offered; an average of .13 clinical hours per client/per month or .78 clinical hours over six months. Last CPR, a total of 94.75 clinical individual and groups hours offered; an average of .4 clinical hours per client/month or 2.4 clinical hours over six months Data obtained from MMRs

Elopement & Client Restraints New Clients - CSNH Elopement & Client Restraints Client Elopements Dec. 2014 – May 2015 Sept. 2013 – Feb. 2014 CSNH Client Restraints Dec. 2014 – May 2015 Sept. 2013 – Feb. 2014 CSNH Data obtained from MMRs

MEDICATION INCIDENTS & OCCURRENCES A total of 0 incidents and 2 medication occurrences Last CPR, a total of 0 medication incidents and occurrences Data obtained from MMRs

KEY MMR RESULTS Client incidents involving contraband = 0 Site visits from outside funders = 5 Written commendations resulting from site visits by outside regulators/funders = 3 Written deficiencies resulting from outside regulators/funders = 8 Keene and Manchester: 37 clients at end of May 2015 1 out of 37 competitively employed Department success with individual's community involvement average of 97.8% over six months; Keene = 98%; Manchester = 97.5%; Last CPR = 92.1% : Keene = 90%; Manchester = 94.2%

CPR ACTION PLAN (Next 6 months) Proposed Objective Proposed Timeline #1. Expand Community Participation Services (Day Program) by 4 individuals – 1 in Manchester, 1 in Keene and 2 in Peterborough. Also expand residential services by 2 – 1 in Keene/Peterborough and 1 in Manchester Expand by 2 individuals by November 2015 #2 Decrease the amount of time to recruit and hire Direct Support Professional’s. Completed and maintained by November 2015 #3. Reduce the number of open DSP position to less than two FTEs at any given time. Completed by November 2015 #4. Complete marketing material and update the web site for shared living, employment and Active Life Programs.