COMMUNITY STRATEGIES: New Hampshire Comprehensive Program Review June 28, 2013

HIGHLIGHTS 3 new programs in Active Life – Keene Day Program – (two 30 hour program [David J. and Jessica B.] and 1 new 20 hour program (Brian B.]) Charles Richwine, Program Coordinator, was chosen by the area agency and will become a certified Gentle Teaching Trainer by September. Keene Day Program has become recognized by the Area Agency (MDS) as the best day program in the region.  Demonstrated success teaching relaxation and mindfulness techniques

HIGHLIGHTS BEST PRACTICE: Actively engaged in system-level discussions on better integration of developmental, acquired brain injury, mental health, substance use and primary care services Developing new process for review and revision of program rules and protocols involving all stakeholders CLIENT RELATED: Selden, who is 58 years old, is learning to read for the first time in his life. He can now recognize 42 words and read them in sentences. Corey went on vacation to Branson, MI alone with a group tour. Several other individuals also took vacation (to Florida, Michigan, and on a cruise) with minimum staff supervision.

CHALLENGES Reorganizing Unity House and changing the milieu Finding staff to fill 2nd shifts and weekend Closing of Newmarket Our ability to address co-occurring disorders Reducing the use of intrusive interventions like restraint, police involvement, and/or hospitalization Maintaining equality of clinical and administrative support

STAFFING Staff Turnover Rates Performance Evaluations Staff Training

STAFF TURNOVER RATES The current CSNH turnover rate is 33.8%; compared to the last CPR of 23.4% Last CPR: Keene = 20%; Manchester = 17%; Unity = 0%; Individual Sites = 19% (May 2012 – October 2012) Data obtained from HR Reports

OVERDUE PERFORMANCE EVALUATIONS STAFFING OVERDUE PERFORMANCE EVALUATIONS November 2012 – April 2013 Overdue Evaluations As of April 30, 2013   FT PT Keene 4 3 Manchester 2 Unity Individual Sites 1 Totals 10 May 2012 – October 2012 Overdue Evaluations As of October 31, 2012   FT PT Keene 4 Manchester Unity 1 Individual Sites 6 2 Totals 11 Total of 10 FTEs and 4 PTEs overdue performance evaluations; this is a 21% decrease in overdue evaluations Last CPR, a total of 11 FTEs and 6 PTEs overdue performance evaluations from May 2012 – October 2012 Data obtained from HR Department & HR Personnel Summary

(combined with Manchester STAFF TRAINING HOURS November 2012- April 2013 E Training Hours MMR Training Hours Total Keene 104.75 Unity House 13.75 Newmarket Program (combined with Manchester N/A Manchester 67.5 Totals 186 145 331 MMR Training Hours = combined and not sorted by individual programs May 2012- October 2012 E Training Hours MMR Training Hours Total Keene 91 Unity House 58 Newmarket Program 8.25 Manchester 18.75 Totals 176 85 261 MMR Training Hours = combined and not sorted by individual programs A total of 331 training hours completed (November 2012 – April 2013); an average of 7.4 training hours per staff/six months. This is a 2.7% decrease from the last CPR Last CPR, a total of 261 training hours were completed May 2012 – October 2012 Average of 7.6 training hours per staff/six months Data obtained from MMRs and HR Reports

CLIENT RELATED Clinical Hours Elopements Restraints New Clients Medication

CLINICAL HOURS November 2012 – April 2013 Average of .62 clinical hours per client/month; Total Clinical Hours = 180. This is a 22% decrease from the last CPR. Last CPR, Average of 0.79 clinical hours per client/month; Total Clinical Hours = 39; (May 2012 – October 2012) Data obtained from MMRs

Client Elopements Client Restraints New Clients - CSNH Client Elopements November 2012 – April 2013 May 2012 – August 2012 CSNH Client Restraints November 2012 – April 2013 May 2012 – August 2012 CSNH 8 1 Data obtained from MMRs

MEDICATION INCIDENTS & OCCURRENCES A total of 4 medication incidents and occurrences . This is an increase of 400% of medication incidents and occurrences from the last CPR. Last CPR, a total of 0 medication incidents and occurrences (May 2012 – October 2012) Data obtained from MMRs

KEY MMR RESULTS 6 site visits by outside funders Department success with individual's community involvement average of 92% over six months “0” client incidents involving contraband

CPR ACTION PLAN See Handout