1. Four Corners Community Behavioral Health Center Presented by Aralias Research Aralias Research Ryan Jensen, Marcus Waite, and Nick Bell

2. Brief History of FCCBH Provides mental health and substance abuse services to adults, youth, and children in Carbon, Emery and Grand Counties Serves Southeastern Utah since 1972 Staff includes: psychiatrists, psychologists, licensed clinical social workers, licensed professional counselors, licensed substance abuse counselors, registered nurses, advanced practice registered nurses, case managers, family advocates and more

3. Objectives of Research Project Draw comparisons to past Medicaid studies (specifically, Maximus 2002 survey research explaining 2002 numbers) to respond to the question, “How does client satisfaction now compare to 2002 client satisfaction?” Determine in what areas of service FCCBH is doing well Determine in what areas FCCBH can improve its service

4. Methodology and Sample Size Exploratory Research Secondary Research Primary Research Sample Size

5. Exploratory Research Methods Discussed with FCCBH staff via Marilyn Mitchell to obtain direction and objectives for the project - Built/revised previous Medicaid questionnaire

6. Secondary Research Methods Examined previous Medicaid survey –Used as a template for performing revisions and drawing comparisons Studied both Maximus 2002 and GMP surveys and results –Determined categories for comparisons from Maximus 2002 survey –Determined low scoring or problem questions within Maximus 2002 survey

7. Primary Research Methods and Sample Size Staff input –Throughout development and completion of the questionnaires, Aralias Research received input from FCCBH staff Phone Questionnaire –Performed 90 surveys assessing client satisfaction 35 Adult surveys 30 Child surveys (Parent Proxy) 25 Youth surveys

8. Potential Errors and Biases Sampling Error- does the sample represent the entire population? –Sample was generated using a random number generator Response Error- did the respondents understand and answer all the questions in the questionnaire? We controlled the understanding and response rates for each question Distractions such as TV, family, other engagements, and mood may skew results Non-Response Error- were there non-respondents? –Several phones were disconnected –No Answers (not home or not answering)

9. Summary of Responses Adult –35 Adults were surveyed Ages 18 + –46 Questions were asked Youth & Children –55 Youth and Parent Surveys Ages 0 – 12 (Child with Proxy Parents) Ages 13 – 17 (Youth)

10. Youth/Parent Survey Satisfaction Category Comparisons 1. Location and Time of Services 2. Knowledge of Access to Emergency Care 3. Scope of Service 4. Timeliness of Services 5. Access to Transportation 6. Access to Complaint Process 7. Staff Interaction and Service Quality 8. Quality of Medical Management Services 9. Cultural Sensitivity 10. Treatment 11. Improved Interpersonal Relations 12. Overall Satisfaction

11. Location and Time of Services Question #18: The location of services was convenient. Question #19: Services were available during hours that were convenient.

12. Knowledge of Access to Emergency Care Question #24: My caregivers adequately explained how to get emergency mental health services if I wanted them.

13. Scope of Services Question #23: “I got the help I needed.”Question #8: “I feel that my opinion was valued in choosing the services I received.” Question #17: “I received services that were right for me.”

14. Timeliness of Service Question #11: “I felt I had someone to talk to when I was troubled.” Question #20: “I was able to get appointments with my caregivers as soon as I wanted.”

15. Access to Transportation Question #32: “My caregivers helped me with transportation to and from mental health services when I needed it.”

16. Access to Complaint Process Question #25: “I felt free to complain when I was unhappy with the services provided.” Question #26: “My caregivers or office staff adequately explained to me how to file a complaint if I had one.”

17. Staff Interaction and Service Quality Question #12: “I felt comfortable asking questions about my treatment.” Question #15: “The people helping me listened to what I had to say.” Question #29: “My caregivers spoke with me in a way that I understood.” Question #27: “My caregivers treated me with courtesy and respect.” Question #28: “Office staff treated me with courtesy and respect.”

18. Staff Interaction and Service Quality (cont.) Question #10: “I felt that my caregivers stuck with me no matter what.”

19. Quality of Medical Management Services Question #13: “I felt comfortable asking questions about my medication.”

20. Cultural Sensitivity Question #30: “My caregivers were sensitive to my cultural/ethnic background.” Question #31: “Office staff were sensitive to my cultural/ethnic background.”

21. Treatment Question #9: “I feel my input was valued in choosing my treatment goals.” Question #16: “I was actively involved in my own treatment.”

22. Improved Interpersonal Relations Question #4: “I get along better with friends and other people.” Question #3: “I get along better with family members.” Question #7: “I am satisfied with my family life right now.”

23. Overall Satisfaction Question #21: “If I need services in the future, I would use these services again.” Question #22: “I got the help I wanted.”

24. Adult Survey Satisfaction Category Comparisons 1. Timeliness of Service 2. Scope of Service 3. Cultural Sensitivity 4. Access to Transportation 5. Service Quality

25. Timeliness of Service (Adult) Question #5: My caregivers were willing to help as often as I felt necessary.

26. Scope of Service (Adult) Question #8: I was able to get all the services I thought I needed.

27. Cultural Sensitivity (Adult) Question # 24: My caregivers were sensitive to my cultural/ethnic background. Question # 25: The office staff was sensitive to my cultural/ethnic background.

28. Access to Transportation (Adult) Question #29: My caregivers helped me to mental health services when I needed it.

29. Service Quality (Adult) Question #28: My caregivers were competent and knowledgeable.

30. If you could see one thing improved…what would it be?  More counselors and appointment openings “My child needs frequent visits for better attention.” “My child needs frequent visits for better attention.” “FCCBH needs more counselors to free up more time for my child’s to have time with his counselor.” “FCCBH needs more counselors to free up more time for my child’s to have time with his counselor.” “More available therapists for one-on-one counseling.” “More available therapists for one-on-one counseling.”  Closer 24-hour crisis center  After school appointments “Don’t make my child miss school.” “Don’t make my child miss school.” “More variety of services to accommodate youth and children.” “More variety of services to accommodate youth and children.”

31. What was the single most helpful service received at FCCBH?  “[My son’s] mental health has improved a great deal.” (2 to a 6 on question #35)  “Lorna Jensen. She is good and does her best to help.”  “My child has had someone to talk to.”  “The therapy my child received helped realize he isn’t a bad kid and gave him alternative solutions to his past behavior.”  “Everyone helps everyone. It helps to know they are there.”

32. Chi-Square Tests for Statistical Significance The following chi-square tests show response category comparisons where statistical significance (minimum 90% confidence level) was found in the association between the two response categories: The following chi-square tests show response category comparisons where statistical significance (minimum 90% confidence level) was found in the association between the two response categories: 1. Frequency of Visits vs. Overall Satisfaction 2. Scope vs. Overall Satisfaction 3. Timeliness vs. Overall Satisfaction 4. Treatment vs. Overall Satisfaction

33. Frequency of Visits vs. Overall Satisfaction For 30 df the Pearson Chi-Square value is 40.2560.

34. Scope vs. Overall Satisfaction For 20 df the Pearson Chi-Square value is 28.4120.

35. Scope vs. Overall Satisfaction For 12 df the Pearson Chi-Square value is 18.5494.

36. Treatment vs. Overall Satisfaction For 20 df the Pearson Chi-Square value is 28.4120.

37. Treatment vs. Overall Satisfaction For 12 df the Pearson Chi-Square value is 18.5494.

38. How is FCCBH doing now? (Youth/Parent comparisons) CATEGORYCOMPARISONSMaximus2002TOTALS BYU 2003 SurveyTOTALSIncreaseorDecrease? 1.Location and Time of Services 61.90%80.00%18.10% 2.Knowledge of Access to Emergency Care 48.30%74.54%27.15% 3.Scope of Service 42.7% and 32.8%88.18% and 54.55%33.62% 4.Timeliness of Services 40.40%74.55%34.15% 5.Access to Transportation 33.30%56.36%23.06% 6.Access to Complaint Process 77% and 21.456.36% and 78.18%18.07% 7.Staff Interaction and Service Quality 40.87% and 16.6%55.05% and 32.93%15.25% 8.Quality of Medical Management Services 42.6% and 19.1%40% and 25.45%1.88% 9.Cultural Sensitivity 48% and 12%66.36% and 25.45%15.91% 10.Treatment 42.6% and 9.8%60% and 24.55%16.08% 11.Improved Interpersonal Relations Not Available54.09% and 14.09%Not Available 12.Overall Satisfaction 31.3% and 16.45%24.54% and 54.5415.67%

39. How is FCCBH doing now? (Adult comparisons) CATEGORYCOMPARISONSMaximus2002TOTALS BYU 2003 SurveyTOTALSIncreaseorDecrease? Timeliness of Services77.10%88.57%11.47% Scope of Services24.80%45.71%20.91% Cultural Sensitivity70.50%65.71%(4.79%) Access to Transportation52.80%38.57%(14.23%) Service Quality10.30%32.86%22.56%

40. Summarized Results…

41. Conclusions Areas of Concern: Areas of Concern: –Access to Transportation for adults (14.23% decrease) –Quality of Medical Management Services for youth and children (only a 1.88% increase) Greatest Accomplishments: Greatest Accomplishments: –Service Quality among adults (22.56% increase) –Scope of Services for all clients (20.91% increase for adults and 33.63% increase youth/children) –Timeliness of Services (11.47% increase for adults and 34.15% increase for youth/children)