1. Places for People: Initial Outcome Results for People Served After One Year
Gary Morse, Ph.D.
Mary York, LMSW
Nathan Dell, AM, LMSW
December 12, 2016
Analyses based on outcomes data collected between 1/2014 and 1/2016 for 327 people served

2. OVERALL AGENCY FINDINGS

3. Race

4. Gender

5. Clients by Program Type

6. Housing

7. Primary Care Doctor
P = .059

8. Emergency Room – Any Reason

9. Reasons for Emergency Room Visit*
* P = .052

10. Hospitalization – Any Reason

11. PHQ9 – Depression

12. No Significant Change Other housing categories School/job training
Employment
Overall health
Current smoker
Alcohol use*
Drug use*
Stage of treatment for substance abuse*
Arrests, convictions, jail
*Significant improvements were found between baseline assessment and 6 month, but not between baseline and 1 year

13. Major Conclusions and Implications
Caveats:
Most are not “true baselines”
Small sample sizes for a few programs
Positive changes in some areas, including:
Decreased overall use of ER
Decreased hospitalizations
Both ER & hospital findings are positive for MCO contracts
Decreasing levels of depression

14. Areas needing greater attention?
-SA use overall and ER use for SA
K2 factor?
Need for more IDDT (now underway)
Overall health (PBHCI underway)
Employment
Smoking cessation

15. HIGHLIGHTS OF OUTCOMES BY PROGRAM TYPES

16. Gender

17. Age

18. Race

19. Homeless Status
OAT/Action saw significant decrease in homeless status at 12 months
32% homeless at baseline to 5% at 12 months (p=.021)

20. Health
Increased enrollment into PCP services in the Oat/Action program (61% to 81%, p=.039)
Increase in positive self-assessment of health status for Hope team clients (median “fair” to “good”, p=.022)
Hospitalizations for any reason decreased significantly for OAT/Action (58% to 17%, p<.0005) and Residential clients (55% to 0%, p=.031)

21. Health (cont.)
Significant decrease in ER visits for any reason for OAT/Action clients (53% to 22%, p=.019)
Significant increase in ER visits due to substance use in ACT (6.8% to 16.3%, p=.006)
Significant decrease in ER visits due to physical health for ACT clients (19% to 5%, p=.012), with positive trends for CPRP clients (p=.063)

22. Substance Use
Persons in ACT, who had alcohol abuse or dependence at baseline, reduced the severity of alcohol use at 12 months
27% no longer indicated either alcohol use or dependence (p=.027)

23. Depression (PHQ-9 Scores)
Baseline
12 Months
Mean (SD)
Sig.
ACT
10.48 (7.31)
9.08 (6.58)
.106
CPRP
9.93 (6.5)
6.96 (5.12)
.001
Hope
10.0 (6.78)
7.12 (6.41)
.087
Oat.Action
12.35 (7.78)
10.31 (5.32)
.081
Residential
14.00 (5.59)
10.81 (6.16)
.181
Path
8.46 (4.99)
6.09 (6.14)
.151
3700
7.83 (5.69)
7.14 (4.45)
.940

24. Summary and Major Conclusions by Program Type
Some demographic differences between programs
(e.g., CPRC serving somewhat older and lower rate of African-Americans,
OAT/ACTION somewhat younger and higher rates of African-Americans)

25. Summary and Major Conclusions by Program Type (Continued)
Some differences in rates of progress:
OAT/ACT strongest positive change in
reducing homelessness
obtaining primary care
reducing overall ER and hospital use
Notes: OAT/ACTION more likely to reflect
“true baseline” data and
for persons to be in acute/worse states at program entry
HOPE:
strongest improvement in overall health
 ACT
Strongest decrease in ER for physical reasons
Greatest increase in ER use for SA (K2 factor?)
Strongest decrease for SA from clinical ranges (abuse/dependence)
 CPRP
Strongest reduction in level of depression (thou lower level at baseline)

26. HIGHLIGHTS OF ANALYSIS BY RACE

27. Homeless Status & Depression
African Americans saw positive decreases in homeless status (9.5% to 5.6%, p=.064)
PHQ-9 scores decreased for both races analyzed:
Base
12 Months
Mean (SD)
Sig.
African American
10.23 (6.90)
8.53 (6.12)
.001
Caucasian
10.72 (7.18)
8.66 (6.38)
.023

28. ER & Hospital Use
African Americans reduced ER visits for any reason (35% to 25%, p=.008)
African Americans reduced ER visits for mental health concerns (21% to 10%, p=.057)
African Americans saw significant decrease in hospitalizations (28% to 14%, p<.0005)
Caucasians also decreased hospitalizations, but this was not statistically significant (28% to 15%, p=.064)

29. Summary and Conclusions by Race
Especially strong positive gains for African-Americans in terms of:
Reducing homelessness
Overall use of ER
ER use for MH problems
Hospitalizations (also a trend for Caucasians)
Depression (also significant for Caucasians)