COMMUNITY STRATEGIES: Angelo Maroun Abington, Bellingham, Leominster-Betanray, Leominster-Elm, Leominster-Wachusett, and Marlborough Comprehensive Program Review March 28,

Caring Force cluster involvement/Rally at Statehouse participation 5 Promotions New employment initiatives: Wal-Mart, Liberty Tax, and Salvation Army. 2

 New cluster configuration: new people, managers, clients  Utilization: still one bed open in Bellingham  Employment procurement  New performance appraisal system 3

STAFFING Staff Turnover Rates Staff Retention Rates Performance Evaluations Staff Training 4

STAFF TURNOVER RATES  Cluster average is 30.2% compared to the CSMA average of 26.5%  Last CPR, Cluster average was 34% compared to the CSMA average of 24% Data obtained from HR Reports 5

STAFF RETENTION RATES  6/30/13 Retention Data for CSMA; CSNH; and Overall-CRJ = N/A (data not available) Data obtained from HR Reports 6

OVERDUE PERFORMANCE EVALUATIONS August 2013 – January 2014Overdue Evaluations As of January 31, 2014 Overdue Evaluations As of March 31, 2013 ANNUAL REVIEWS FTPTFTPT Abington0120 Bellingham0020 Leo-Betanray0000 Leo - Elm1040 Leo - Wachusetts1000 Marlborough0100 Cluster - Totals2280  This CPR, a total 4 annual reviews: 2FT and 2 PT are due; last CPR = 8 FT and 0 PT  This is a decrease of 50% from previous CPR. Data obtained from HR Department & HR Personnel Summary 7

 Total of training hours; (23% increase from previous CPR). Average of 20.4 hours per staff over six months.  Last CPR, a total of 959 training hours were completed; Average of 16.4 hours per staff /over six months Data obtained from MMRs and HR Reports 8

CLIENT RELATED Clinical Hours Elopements Medication De-escalation and Restraints Mainstream/Community Inclusion Activities 9

 Total Clinical Hours = (October 2012 – March 2013); Cluster Average of 1.6 clinical hours per client/month  Last CPR, Total Clinical Hours = 271 (March 2012 – August 2012); Cluster Average of 1.6 clinical hours per client/month 10 Data obtained from MMRs

Client Elopements August 2013 – January 2014October 2012 – March 2013 Abington00 Bellingham00 Leo - Betanray10 Leo – Elm (Pleasant)10 Leo- Wachusetts11 Marlborough04 Cluster - Total35 Data obtained from MMRs  Total of 3 walk-aways/elopements reported for this reporting period. This is a 40% decrease from last CPR. 11

Data obtained from MMRs August 2013-January 2014October 2012 – March 2013 Average Per Client/Month Medication Incidents Medication Occurrences TotalAverage Per Client/Month Medication Incidents Medication Occurrences Total Abington Bellingham Leo-Betanray Leo-Elm Leo-Wachusetts Marlborough Cluster  This is a 27% decrease in medication incidents/occurrences from previous CPR.  A total of 3 client medication refusals reported during this timeframe.  A total of 2 client medication refusals reported during this timeframe 12

De-Escalations : Restraints August 2013 – January 2014October 2012 – March 2013 De-escalations: Restraints RatioDe-escalations: Restraints Ratio Abington173:1 216:1 Bellingham172:44:1 549:13 42:1 Leo - Betanray104:335:1 39:0 Leo – Elm (Pleasant)364:735:1537:688:1 Leo -Wachusetts282:1915:1604:1540:1 Marlborough334:1326:1 490:46 11:1 Cluster Totals1,429:11313:1 2,435:143 17:1  Last CPR, the overall Cluster totals = 17:1 Data obtained from MMRs 13

Average Mainstream Activities Participated In and Offered Per Client/ Month (August 2013 – January 2014)  Average of 14.2 mainstream activities participated in by client/month (August 2013 – January 2014). This is a 13% decrease from the previous CPR. The overall participation rate is 87%; This is a 3% decrease from previous CPR. Data obtained from MMRs 14

Average Community Inclusion Activities Participated In and Offered Per Client/ Month (August 2013 – January 2014)  Average of 6.4 inclusion activities participated in by client/month (August 2013 – January 2014). This is a 45% increase from the previous CPR. The overall participation rate is 83%; This is a 10.6% increase from previous CPR. Data obtained from MMRs 15

QUALITY ASSURANCE Key MMR Results 16

Employment/Education: (As of January 31, 2014)  11/27 (41%) of the residents are competitively employed; last CPR = 10/28 (36%)  2/27 (7%) of the residents are in a sheltered workshop; last CPR = 1/28 or (3%)  14/27 (52%) of the clients are in an alternative day program; last CPR = 16/28 (58%) Other:  90% of the residents chose healthy living opportunities in programs; last CPR = 67%.  0 Contraband (Trigger) item found in the programs over this time period; last CPR = 0 Contraband (Trigger) item found Staff Certifications:  100% of staff are current in the following certifications: PAC/CPI; FA/CPR/AED  78.3% of the staff are MAP certified; last CPR = 72% o Current CPR: Abington 88%; Bellingham 80%; Betanray = 100%; Elm (formerly Pleasant) 50%; Wachusetts 88%; Marlborough 64% o Last CPR: Abington 75%; Bellingham 64%; Betanray = 78%; Elm (formerly Pleasant) 73%; Wachusetts 78%; Marlborough 64% 17

ISSUE: Need to improve number of clients participating in healthy living COMMENTS: Last CPR, clients participating in healthy living programming = 67% IMPROVEMENTS MADE: Currently, 90% participating in healthy living programming (34% increase from last CPR) ISSUE: Increase Community Inclusion COMMENTS: Last CPR, average of 4.4 community inclusion activities per client/month IMPROVEMENTS MADE: Currently, average of 6.4 community inclusion activities per client/month (45% increase from last CPR) ISSUE: Decrease medication incidents & occurrences COMMENTS: Last CPR, the total medication incidents & occurrences = 11 IMPROVEMENTS MADE: Currently, a total of 8 medication incidents & occurrences ISSUE: Improve on the Overdue Performance Evaluation Completion COMMENTS: Last CPR, 8 FT performance evaluations were overdue IMPROVEMENTS MADE: Currently, 4 evaluations are overdue: 2 FT and 2 PT KEEP EYE ON: Improve Meaningful Day activities – finding things all clients like to do and find how to market products made by the clients. Improve recruitment period (fill vacancies sooner) so as to eliminate overtime. 18