Transcript Cuyahoga CountyStat Preparation. Evaluation. Innovation.

Cuyahoga CountyStat
Preparation. Evaluation. Innovation.
Division of Senior and Adult Services (DSAS)
Date: 01/16/14, Presentation #12
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Action Items
Executive Debriefing: October 21, 2013
1. Break out medical/nursing home referral data. Are some institutions better or worse
than others? Which ones are good at identifying problems? (See slide 12)
2. Begin to add more info to website that directs seniors and their caregivers to more
resources, including for veterans, Affordable Care Act, etc. Do other counties do
this? Check their sites. (See slide 7)
3. Provide more information on $700,000 variance in revenue. (See slide 24)
Other Discussion Items:
1. Continue to benchmark all measures
2. Continue to track productivity
3. Continue to identify best practices as appropriate
4. Catalogue your internal promising practices
3
Action Item-Records Retention Initiative
Objective: To effectively adhere to the state’s Public Records Law and manage and
facilitate access to agency information in order to support and accelerate decision
making and ensure accountability.
•
Public Records Policy and RC-2 were completed in 2012; will be reviewed in 2014
•
DSAS staff completed training on County Public Records Portal in July
•
Reviews of agency records were processed in December by Records Managers and the
Records Coordinator on the inventory of records submitted by all program areas
•
DSAS staff conducting ongoing meetings to standardize process improvements for client
record retention
•
All DSAS Public Records Managers and relevant staff attended mandatory Sunshine Law
training in September
•
Need for records scanning system to address storage challenges and improve casework
efficiency; New Case Management system will assist with this challenge
4
2014-2016 DSAS Strategic Plan Goals and Objectives
Create Programmatic Centers of Excellence to Foster Collaboration and Best Practices
• Explore and implement models of care that empower clients to make individual choices that support their
independence
• Ensure customers have “no wrong door” access to services needed
• Ensure that all programs are culturally and linguistically competent
• Seek out expertise and integrate efforts with clinical and academic partners
• Support families and caregivers by providing services including respite care and education
Raise the Public Profile for Multiple Audiences
• Develop and implement an agency-wide marketing initiative
• Expand public relations, marketing, and outreach efforts to promote and increase visibility
• Create a system to educate the public about timely and relevant issues
Establish a Leadership Role in the Community
• Advocate for seniors and adults with disabilities
• Collectively address gaps in service: Transportation, Mental Health, and Housing
• Engage in successful aging initiatives that foster volunteering, civic engagement, and lifelong learning opportunities
Strengthen Funding and Service Delivery Capacity
• Eligibility Determination: Assess eligibility requirements for services and to communicate clear guidelines for
eligibility
• Maximize reimbursement for services
• Service Delivery Capacity: Evaluate service capacity of programs and ensure financial accountability
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DSAS Strategic Plan-Key Western Reserve Plan Principles
Goal 4 - Human Service Needs - Aligning and coordinating both public and private resources around our
most pressing human service needs
• Collaboration with community partners, such as United Way 211, and Health and Human Service agencies
• Initiatives to obtain grants
Goal 5 - Education - Identifying education from early childhood forward, as the central factor in individual and
community success
• Expand education opportunities at Senior Centers
• Explore collaborations with colleges to provide education opportunities for seniors
Goal 12 - Good Government - Creating a culture within county government which implements nationallyrecognized good government practices and innovations
• Create Centers of Excellence
• Utilize technology to streamline case management and provide enriched data
• Develop performance and process-based outcomes, comparing data to established benchmarks
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DSAS Strategic Plan Phase 3-Performance Measurement
The mission of DSAS is to
empower seniors and adults
with disabilities to age
successfully by providing
resources and support that
preserves their independence
Performance
Measures-Process
Improvements
Centralized Intake
Case Management
System
Performance
Measures-Client
Outcomes
Client Satisfaction
Health and well-being
outcomes
• New SMART Objectives in 2014 will include: Calls received through Centralized Intake (and measures associated with this);
Services provided through Information and Outreach Unit (IOU)/Aging and Disability Resource Network (ADRN); Reduction in
ER and Hospitalization (Home Support Unit)
• Complete analysis of more than 500 customer satisfaction surveys received in 2013 will be completed by March 2014
• 2013 Statistical Performance Report will be completed by March 2014
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Action Item-Website Improvements
Meeting held with DSAS Office on Aging and County DOIT on 12/9/13
•
Website will be re-designed to be more interactive and user-friendly
•
Links to County social media sites, including You Tube and Twitter , with DSAS media, will be available
•
Website landing pages will be redesigned to make them more "senior-friendly”
▫ Options for enlarging the type size
▫ Minimizing the use of jargon and technical terms
▫ Providing a speech function to hear text, functions to minimize scrolling, and bilingual scripts
•
A searchable database of services and resources will be created
•
A series of videos will be produced and uploaded to website and will include:
▫ An introduction to DSAS video
▫ A "Call to Action" video about Adult Protective Services and other policy issues relevant to seniors
▫ A video announcing our new Centralized Intake number (“One Call Does it All” campaign); and
videos highlighting signature events
•
A portal for Advisory Committee Members to log-in to for special updates will be developed
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Adult Protective Services Unit
Adult Protective Services (APS) is mandated to protect and assist adults who
may be victims of abuse, neglect, self-neglect, and financial exploitation.
SMART Objective
By 12/31/2013, APS will reduce the rate of recidivism of reported cases of alleged
abuse, neglect, self-neglect, and/or exploitation to 25%.
* Data through 09/30/2013
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Adult Protective Services Unit
Allegations and Validations
Description
2010
2011
2012
2013 YTD**
Alleged Abuse
472
425
403
343
Alleged Neglect
914
849
824
682
Alleged Self-Neglect
1,513
1,440
1,461
1,131
Alleged Exploitation
609
582
579
412
Alleged Hoarding*
1
103
178
153
Total Allegations
3,509
3,399
3,445
2,721
Validated Abuse
171
152
158
167
Validated Neglect
344
344
303
350
Validated Self-Neglect
1,066
1,022
1,023
864
Validated Exploitation
213
174
205
188
Validated Hoarding*
0
72
106
79
Total Validations of
Allegations
1,794
1,764
1,795
1,648
*Hoarding Allegations and Validations were tracked beginning in mid-2011.
** 2013 Data through 9/30/2013
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Adult Protective Services Unit-Benchmarking Data
County*
Montgomery
County
Ohio (2012)
SMART Objective
28%
Data not available
Allegations validated
61%
Investigations
completed
1,382
Investigations
occurred within
timeframe
85%
Cases closed with
services in place
85%
Customer Satisfaction
75%
Cuyahoga
Franklin County
Ohio (2012)
Texas (2012)
Data not available
Data not available
16.3%
36%
64%
52%
68%
234
366
3,744
21,877
Data not available
Data not available
Data not available
Data not available
Data not available
Data not available
Data not available
Data not available
Data not available
Ohio (2012)
Highlights

New reports to provide better statistical information and supervisory oversight have been developed
* Data as of 9/30/13
91%
89%
98%
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Adult Protective Services Unit
Referral Sources
1) Mandated
reporters
2) Non-Mandated
reporters
3) Self referrals
4) After hours
hotline referrals
696-KIDS
Case assigned
for an APS
Investigation
Abuse /
Neglect /
Exploitation
Validated?
APS
initiates the
Investigation
No:
Protective
Not Needed
Case
Terminated
Yes
Yes:
Protective
Needed
No
Non-voluntary intervention:
APS involves
Assistant Prosecuting Attorney (APA)
Does
adult have
capacity?
Adult
willing to
accept
services?
Probate Court Hearings:
Protective Service Orders
Conservatorships
Guardianships
No
Yes
Educate the
adult and/or
family
members
Implement
safety plan –
service
referrals &
linkages
Alleviate
risk to
client
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Action Item-Adult Protective Services (APS)-Source of Referrals
• Data based on 1,593 referrals from January through September 2013
• 10% of APS clients are veterans
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Information Outreach Unit
The Information Outreach Unit improves the economic well-being of seniors and disabled
adults by helping them to navigate through, link with, and enroll in the complex network of
social service benefits.
SMART Objective
By 12/31/2013, Information Outreach will link clients with a total of $500,000 in cost-saving benefits.
Target 2013
Target in 2012 was $350,000. Due to additional staff and planned events, goal was raised for 2013
Target number of clients served in 2013 is 5,000; Through 3Q 2013, IOU has served 3,784 clients
* YTD as of 9/30/13
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Home Support Unit
Home Support provides home-based personal care (such as assistance
with bathing, dressing, and grooming) and homemaking (such as light
housekeeping and laundry) to high-need clients.
SMART Objective
By 12/31/2013, 90% of clients will have a completed home assessment within 10 days of referral.
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Home Support Unit
Benchmarking Data
Cuyahoga County*
Ohio
Average (2012)**
National
Average (2012)**
Visiting Nurse
AssociationCleveland (2012)**
SMART Objective
67%
91%
91%
87%
Client Satisfaction
(2013)
93%
82%
84%
84%
New measures to be collected and benchmarked will include:
• How often clients receiving home health care need any unplanned ER care
• How often home health clients had to be admitted to the hospital
• Falls screen (individual client information and aggregate data)
• Depression screen (individual client information and aggregate data)
* Cumulate YTD Data as of 9/30/13
** Source Data: http://www.medicare.gov/HomeHealthCompare
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Options Unit
Options serves seniors with limited income who need help coordinating and financing their
multiple home care needs, but are not eligible for PASSPORT services or Medicaid reimbursements for
services to assist in maintaining independence.
SMART Objective
By 12/31/2013, the Options Unit will increase the number of clients who report being
linked to additional (non-Options) services to 90%.
* Data as of 9/30/13
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Options Unit
Benchmarking Data
Cuyahoga County*
Midwest Region
Average (2012)**
National
Average (2012)**
Franklin County
Ohio (2012)
SMART Objective
83%
80.1%
71.4%
Data not available
90% of home visits completed
within 10 days
96%
Data not
available
Data not available
Required visit within
3-4 weeks; compliance
not tracked
Caseload (2013)
81 per case manager
(ILOC & PLOC***)
Data not
available
Data not available
40-45 per case manager
(ILOC)
Client Satisfaction (2013)
88%
79.6%
78.1%
96%
* YTD Data as of 9/30/13
** Source Data: http://agidnet.org/CustomTables/NPS/Data/ (Aging Integrated Database)
***ILOC (Intermediate Level of Care) and PLOC (Protective Level of Care)
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DSAS Overview
DSAS Client Count
2010
2011
2012
2013 YTD*
Adult Protective Services
2,182
2,003
1,975
1,499
Information Outreach
2,516
2,187
3,965
3,784
Options
1,480
1,497
1,438
1,263
650
550
546
484
Intake
11,713
13,008
13,540
10,983
Community Social Services Program (CSSP)
1,076
1,057
1,114
1,264
Total Clients
19,935
20,616
22,889
19,277
Home Support
CSSP Units Provided
Adult Development (Hours of service)
146,482
140,944
149,038
122,824
Transportation (Number of 1-way rides)
53,614
90,826
95,784
90,384
Congregate Meals (Number of Meals)
25,301
28,399
27,494
27,369
* 2013 YTD as of 9/30/13
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Universal Measure - Staff Accountability
Activity
Frequency
Direct Service Accountability Measures
Review of Home Health Aide GPS reports (selected randomly)
Social workers submit calendars for monitoring
Supervisors complete home visits with social workers
Quality Assurance case reviews
40 per month (2 per day)
Weekly
One visit per worker per
month
30 per month
Travel Accountability Measures
Supervisors review travel reimbursement reports submitted by workers
Average of 100 per month
Financial unit checks all travel reimbursement reports before processing
Average of 100 per month
Travel reimbursement reports audited to verify accuracy (selected randomly)
10 per month
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Division Organizational Structure
Administrator
( 2 FTEs)
Deputy Director
Community-Based
(2 FTEs)
Adult Protective
Services Unit
(41 FTEs)
Information
Outreach Unit
(9 FTEs)
Professional
Development Unit
(0 FTE)
Deputy Director
Clinical
(2 FTEs)
Home
Support Unit
(70 FTEs)
Office on Aging &
Operations
(7 FTEs)
Options Unit
(19 FTEs)
Financial Services
(5 FTEs)
Records
Management
(1 FTE)
Procurement &
Contractual Services
(8 FTEs)
Performance
Management (2 FTEs)
168 FTEs
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Universal Measure - Personnel
Program/Area
Staff
Vacancies
Administrator's Office
9
0
Financial Services
5
1
Procurement & Contract Svcs.
8
1
Adult Protective Services Unit
43
0
Information Outreach Unit
9
1
Professional Development Unit
0
1
Home Support Unit
73
5
Options Unit
19
0
Performance Management
2
0
168
9
Total*
* Staff totals through November 2013
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Universal Measure - Personnel
Disciplinary Action*
2013
2010
2011
2012
(through November)
Verbal Counseling
NR*
NR*
8
14
Written Reprimand
1
NR*
2
5
Suspension
2
6
2
1
Termination
3
2
2
1
Pre-Disciplinary Conference
2
1
0
4
*Data not available from Human Resources.
Staff Attrition
2013
2010
2011
2012
(through November)
2
4
2
4
Retired
21
4
4
2
Resigned
8
11
11
7
Laid-off
1
1
0
0
Eliminated Positions
0
2
3
0
Transferred to CJFS or
out of the Division
0
67
0
0
Total
32
89
20
13
Disability
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Universal Measure - Productivity
Division of Senior and Adult Services
Staff
2013 Q3
2012 Q3
166
172
DSAS
Total
Hours
DSAS
Average
Hours
County
Average
Hours
DSAS
Total
Hours
DSAS
Average
Hours
County
Average
Hours
SICK Usage
FMLA Usage
COMP Usage
4,758.59
989.33
12.67
28.66
5.96
0.08
23.64
5.21
4.83
3,812.27
608.35
12.50
22.16
3.53
0.07
23.39
4.30
4.78
Total hours of Absence
5,760.59
34.70
33.68
4,433.12
25.77
32.47
Total Hours of Overtime
6.42
0.04
16.75
19.25
0.11
15.62
Data obtained from: http://intranet.cuyahoga.cc/en-US/CountyStat.aspx
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Universal Measure - Budget
2012 ACTUAL
2013 ACTUAL
2014 Budget
GROWTH/REDUCTION
over 2012 REVENUE
Operating Revenue
$4,235,979
$2,758,263
$2,329,478
-45.0%
HHS Subsidy
$12,735,396
$11,631,351
$15,067,720
18.3%
Total Revenue
$16,971,375
$14,389,614
$17,397,198
2.5%
Budget assumes the following revenue sources:
2013 Actual
2014 Budget
Home Support Fees
$
96,415
$
113,417
Options Program Fees
$
142,189
$
147,744
Federal Social Services
$ 1,468,260
$
1,268,034
Social Services Operating
$
191,212
$
191,212
Medicaid Core Waiver
$
24,897
$
28,874
Adult Protective Services
$
17,544
$
17,535
Transfer from Probate Court
$
201,000
$
201,000
Private Grants
$
324,091
$
282,882
Other
$
292,655
$
78,780
Total
$ 2,758,263
$
2,329,478
* Action Item #3, Provide more information on $700,000 variance in revenue was based
on a 2013 projection and is not shown in the above chart
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Universal Measure - Budget
HHS Senior and Adult Services History
• The decrease in 2010 and 2011 was due to staff participation in the Early Retirement Program
(ERIP), in which 55 staff participated. The budget was also reduced due to drops in State funding.
• The decrease in 2011 and 2012 is due to the transfer of the Medicaid Benefits unit to Cuyahoga Job
and Family Services.
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Universal Measure - Budget
HHS Senior and Adult Services by Expense Category