PAYNE COUNTY YOUTH SERVICES

FY 2011 MANAGEMENT REPORT

JULY 1, 2010 – JUNE 30, 2011

FY 2010 Management Report

Table of Contents

Organizational Plan...... / Page 3
Program Plan...... / Page 3
Community Needs Assessment...... / Page 3
Quality Assessment...... / Page 4
Goals and Objectives...... / Page 5
Data Collection...... / Page 6
Effectiveness Measures...... / Page 6
Clients Reaching GAF Goal………………………………. / Page 6
Accessibility Measures...... / Page 6
Consumer Satisfaction...... / Page 7
Outcomes Summary………………………………………. / Page 7
Critical Incidents...... / Page 7
Grievances...... / Page 8
Agency Financial Position / Personnel Issues...... / Page 8
Quality Assurance Plans...... / Page 9
Attachments...... / Page 10
A. / Organizational Plan ’12...... / Page 11
B. / Program Plan ’12...... / Page 15
C. / Agency Goals, Objectives, and Tasks ’12...... / Page 18
D. / Accessibility Plan ’12...... / Page 23
E. / Cultural Competency Plan ’12...... / Page 24
F. / Risk Management Plan ’12...... / Page 25
G. / Risk Management Assessment...... / Page 27
H. / Technology and System Plan ’12...... / Page 31
Service Delivery Improvement Plans
I. / Out Patient Behavioral Health (Counseling)...... / Page 37
J. / Out Patient Behavioral Health (Substance Abuse)... / Page 38
K. / Out Patient Behavioral Health (Case Management) / Page 39
L. / Out Patient Psychoeducational Groups……………. / Page 40
M. / Workforce Investment Program (WIA)…………… / Page 41
N. / Emergency Youth Shelter…………………………. / Page 42
O. / Healthy Steps Program……………………………. / Page 43
P. / Safe Place………………………………………….. / Page 44


PAYNE COUNTY YOUTH SERVICES

FY 2011 MANAGEMENT REPORT

Organizational Plan

Attachment A is a copy of the agency’s FY 2012 Organizational Plan.

Program Plan

Attachment B is a copy of the agency’s FY 2012 Program Plan.

Community Needs Assessment

A community needs assessment was conducted to determine what the community sees as the most pressing issues facing youth and families in our community. A variety of stakeholders received the assessment, including OJA, DHS, schools, churches and others.

It appears from this data that most of the community respondents had a general knowledge of the services of Payne County Youth Services. However, some of those surveyed were not familiar with the specific programs offered. There was an increase in overall awareness of the agency within the community. Respondents indicated general satisfaction with their working relationship with PCYS and the job we are doing.

The top four issues which community respondents identified as community needs were drug and alcohol issues, parenting issues, involvement with court systems and child behavior problems.

In our effort to address needs of the community, PCYS continues to offer the Skills for Success Program for students and parents at the agency, adjustment counseling, mental health counseling, and an ongoing parent support/education group for parents to learn how to better parent their teenagers. PCYS provides on-going anger management groups.

Victims of Crime Act (VOCA) supported counseling is available. Referrals for victims services include compensation, transportation to court, and advocacy. The VOCA counselor also continues to serve on the Child Abuse Prevention Task Force and as an advocate for services for victims.

Payne County Youth Services continues to expand our drug and alcohol services and was recertified for three (3) years by the Oklahoma Department of Mental Health Substance Abuse Services (ODMHSAS) until June 2012. PCYS continues to provide alcohol and other drug psychoeducational groups, and plans are in the works to expand this program to also provide a treatment alcohol and other drug abuse group. Our school-based, office-based and Community-At-Risk (CARS) counseling programs many times are centered upon these youth who are dealing with substance abuse along with stress and depression, resulting in a large number of youth served receiving services for co-occurring disorders.

Problems at school continue to be a focus for our agency. PCYS provides a clinician to each of the secondary schools for school-based individual, family, and crisis intervention counseling in Stillwater, Yale, Cushing, Perkins, Ripley, and Glencoe.

Responding to a request from the Stillwater Middle School for assistance with a specific group of youth this spring, PCYS has contracted with Stillwater Public Schools to provide a Life Skills/Character Building Group, at the Stillwater Middle School, Junior High and Lincoln Academy. This new group will be called The Character Enhancement Group.

PCYS has provided a cyber-bullying prevention program to Morrison Public Schools, at their request.

Additionally, PCYS provides the Workforce Investment Act (WIA) Program that provides life skills education, tutoring, school-completion, job-readiness, job shadowing and worksite experience, and other services to increase the number of youth moving into the job market in Payne County.

PCYS continues to explore the possibility of adding a youth-centered grief/loss group

to our services.

PCYS has continued to provide the “Within My Reach” curriculum and has piloted a program to provide this relationship psychoeducational group to educate participants in the TANF program. Referred by the Payne County Office of DHS, the groups provide valuable presentation information to parents. Participants are able to complete certain DHS TANF requirements through successful completion of the program. PCYS is considering opening this group up to the general public in the winter of 2011.

PCYS is also expanding its services to meet critical prevention needs of our community in providing the Healthy Steps Program. Targeting children ages birth-5 years and their families, Healthy Steps breaks down barriers to services by providing this screening in the offices of the pediatricians at the Stillwater practice of the Warren Clinic. Those receiving services will benefit from an evidenced-based program that will address major behavioral and developmental issues, emphasizing prevention and treatment. Services will be provided by Early Childhood Development Specialists. As a pilot program in conjunction with the Payne County Early Childhood Coalition, PCYS anticipates direct services to clients to begin in November, 2011.

The PCYS Safe Place Program and Emergency Youth Shelter continue to provide critical emergency shelter to youth in crisis. The PCYS Safe Place Program has expanded to 59 sites, including the OSU Big Orange Bus System. 26 youth accessed Safe Place during FY 2011.

The PCYS Emergency Youth Shelter, licensed for 17 beds by DHS, has housed 156 youth this fiscal year for a total of 2,283 shelter care days. Providing for al needs of the youth while in residence, PCYS has provided educational opportunities in accordance with the McKenny Vento Act, recreational opportunities, life skills, counseling and other needs of each youth. Many youth are experiencing longer stays in our facility with many staying for a number of months during a single placement and returning for multiple placements throughout their adolescence.

Quality Assessment

As an agency accredited by the Commission on Accreditation of Rehabilitative Facilities (CARF), certified by the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS), and a Certified Youth Service Agency and member in good standing of the Oklahoma Association of Youth Services (OAYS), Payne County Youth Services has demonstrated a significant commitment to quality in the services we provide. PCYS was reviewed by the Office of Juvenile Affairs (OJA) and OAYS, and received a 100% compliance rating from both reviewers. PCYS was reaccredited by CARF in June, 2011, for 3 years. PCYS received outstanding results from the survey with a 99.9% compliance rating. The next accreditation audit will be due in 2014.

Payne County Youth Services conducts quality assessment activities in a variety of ways. The Quality Assurance Team meets quarterly to review case files to ensure they are current and accurately reflect the work being done with clients. The Quality Assurance Team also reviews effectiveness and accessibility measures, client satisfaction data, and community needs assessments to look at trends and make recommendations for improving service delivery.

Our goal is for a majority of the charts reviewed to have 90% or above of the items reviewed to be correct. This benchmark has been met each quarter. Deficiencies in files revolved mainly around slight inconsistencies in use of certain forms. No critical concerns were noted and all issues have been addressed through training and QA processes.

Case consultation occurs on a weekly basis, allowing agency service providers to discuss difficult cases and receive feedback from other counselors as to strategies that might be effective in working with their clients. This also provides a forum for counselors to share new and innovative treatment approaches for working with clients, and to receive support to mitigate burn-out in this high-stress field. Suggestions as to treatment planning are documented in the client file along with documentation as to what staff were present at the meeting.

Service Hours

The following table summarizes the number of service hours and number of clients served during FY 2011:

Program / Actual # Clients / Actual Hours
Individual Counseling / 220 / 6,350
Family Counseling / 140 / 1,250
Group Counseling / 120 / 2,000
Skills for Success/First Offender / 40 / 240
VOCA / 82 / NA
Outreach/Schools / 100 / NA
CARS / 23 / 300
Case Management / 450 / 450
Shelter / 156 / 2,283
(shelter care days)
Community Development / Education / 11,000 / NA
WIA / 11 / NA
Information and Referral / 140 / NA
Safe Place / 26 / NA
Safe Place Presentations / 8,400 / NA

*Note: Shelter care days and number of residents represent temporary reduction in capacity to adjust for State funding cuts. Shelter capacity has been capped by PCYS at 8-10 youth during FY11. This cap will continue as necessary to work within anticipated budgetary restraints.

Should PCYS find it necessary to not accept a youth into the Shelter due to reduced capacity, PCYS works closely with the referral sources to meet the sheltering needs of the youth. Consent may be obtained on a case by case basis from the executive director to exceed budgeted capacity for a short time period in order to meet a true emergency placement.

The agency goals and objectives for FY 2012 can be found in Attachment D.

Data Collection

Data was collected in the areas of effectiveness, accessibility, and consumer satisfaction.

Effectiveness Measures -

The effectiveness measure used to track client’s progress was that 80% of the clients would show a 2 or more point increase in their Global Assessment of Functioning (GAF) score at each review.

Clients Reaching GAF Goal -

The Global Assessment of Functioning Scale (GAF) is a numerical scale found in the Diagnostic and Statistical Manual of Mental Disorders (Fourth Addition), which is a manual used by counselors, psychologists and psychiatrists to diagnosis mental illness. The GAF scale measures the client’s overall level of functioning in respect to psychological, social and occupational functioning. The client can be given a score ranging from 0 – 100, the higher the score the higher the person’s level of functioning.

The GAF score is measured at the time of intake, every 90 days during treatment, at discharge, and 90 days post-discharge. The goal is for 80% of the clients to show an increase in GAF score of 2 or more points during a 90-day period or between intake and discharge, whichever is shorter.

FY 2011 GAF outcomes showed an average of 53.5% reaching goal. This does not meet our target of 80% which is due to the high number of extremely complex co-occurring clients presenting with mental health and substance abuse disorders which typically take longer to achieve measurable success. This issue is compounded by the difficulty in accessing appropriate and affordable in-patient substance abuse services for many clients, resulting in them being served in our out-patient setting. We have also discussed challenges in accurate reporting by staff which has been addressed. While not the outcomes we strive for, the quarters for FY11 has continued to improve with first quarter GAF average= 40%; second quarter GAF average = 41%; third quarter GAF average = 65%; and fourth quarter GAF average = 68%.

Accessibility Measures -

One (1) accessibility measure was utilized during Fiscal Year 2011. The accessibility outcome goal is for 100% of clients who request service to be contacted within 15 days.

The agency continues to work hard at ensuring clients are contacted for services within 15 days of referral. We continue to fully utilize our interns and practicum students to complete intakes with clients needing services and then referring the client to the appropriate services inside or outside our agency. We also offer parent education and Skills for Success groups, which allow us to maximize use of counselor time. Should case loads or specific needs make it impossible for a client to be seen at PCYS within 15 days, PCYS staff has many resources to whom we can send a client and family, including Oklahoma State University counseling centers, private providers, and others. All referrals coming into the agency are tracked by the Clinical Director and reviewed by the Executive Director, and through a triage approach, those requiring immediate assistance are seen within 48 hours, or sooner, if at all possible, or provided with referrals for immediate assistance. In FY 2011 99.5% of clients were seen within 15 days.

Consumer Satisfaction -

Client satisfaction surveys are given to or mailed to all active clients every 90 days and at discharge. Clients are asked to indicate their level of agreement with a series of 5 statements measuring their experience at PCYS. Our goal is to average 4 on these responses. For FY 2011, our responses indicate an average of 4.76 on this measure.

Outcomes Summary -

Our measures indicate an overall trend in meeting the goals of accessibility, effectiveness and increase in GAF. The GAF scores measure was not always reached. These measures are indicative of the increasingly complicated clinical cases that staff are seeing, including an increase in resistance associated with a higher incidence of more complicated substance abuse cases.

PCYS continues to experience challenges in obtaining reliable statistics for the Jolts system we are required to use by OJA. To meet the needs of better quantifiable measures, PCYS is currently working with Oklahoma State University to assist us in developing and implementing more accurate and manageable outcomes measures. This system began pilot operations September 1, 2010. PCYS is also undertaking additional Jolts training to improve this data collection measure.