Program__________ Respondent #__________ Role_________ Interviewer____________
Date__________
CRITERION |
RATINGS / ANCHORS |
HUMAN RESOURCES: STRUCTURE &
COMPOSITION |
(1) |
(2) |
(3) |
(4) |
(5) |
| H1 |
SMALL CASELOAD: Client/provider ratio of 10:1. |
50 clients/clinician or more. |
35 - 49 |
21 - 34 |
11 - 20 |
10 clients/clinician or fewer |
| H2 |
TEAM APPROACH: Provider group functions as team rather than
as individual practitioners; clinicians know and work with all clients. |
Fewer than 10% clients with multiple staff face-to-face contacts
in reporting 2-week period. |
10 - 36%. |
37 - 63%. |
64 - 89%. |
90% or more clients have face-to-face contact with > 1
staff member in 2 weeks. |
| H3 |
PROGRAM MEETING: Program meets frequently to plan and review
services for each client. |
Program service-planning for each client usually occurs once/month
or less frequently. |
At least twice/month but less often than once/week. |
At least once/week but less often than twice/week. |
At least twice/week but less often than 4 times/week. |
Program meets at least 4 days/week and reviews each client
each time, even if only briefly. |
| H4 |
PRACTICING TEAM LEADER: Supervisor of front line clinicians
provides direct services. |
Supervisor provides no services. |
Supervisor provides services on rare occasions as backup. |
Supervisor provides services routinely as backup, or less
than 25% of the time. |
Supervisor normally provides services between 25% and 50%
time. |
Supervisor provides services at least 50% time. |
| H5 |
CONTINUITY OF STAFFING: Program maintains same staffing over
time. |
Greater than 80% turnover in 2 years. |
60-80% turnover in 2 years. |
40-59% turnover in 2 years. |
20-39% turnover in 2 years. |
Less than 20% turnover in 2 years. |
| H6 |
STAFF CAPACITY: Program operates at full staffing. |
Program has operated at less than 50% of staffing in past
12 months. |
50-64% |
65-79% |
80-94% |
Program has operated at 95% or more of full staffing in past
12 months. |
| H7 |
PSYCHIATRIST ON STAFF: There is at least one full-time psychiatrist
per 100 clients assigned to work with the program. |
Program for 100 clients has less than .10 FTE regular psychiatrist. |
.10-.39 FTE per 100 clients. |
.40-.69 FTE per 100 clients. |
.70-.99 FTE per 100 clients |
At least one full-time psychiatrist is assigned directly
to a 100-client program. |
| H8 |
NURSE ON STAFF: There are at least two full-time nurses assigned
to work with a 100-client program. |
Program for 100 clients has less than .20 FTE regular nurse. |
.20-.79 FTE per 100 clients. |
.80-1.39 FTE per 100 clients. |
1.40-1.99 FTE per 100 clients. |
Two full-time nurses or more are members of a 100-client
program. |
| H9 |
SUBSTANCE ABUSE SPECIALIST ON STAFF: A 100-client program
includes at least two staff members with 1 year of training or clinical
experience in substance abuse treatment. |
Program has less than .20 FTE S/A expertise per 100 clients. |
.20-.79 FTE per 100 clients. |
.80-1.39 FTE per 100 clients. |
1.40-1.99 FTE per 100 clients. |
Two FTEs or more with 1 year S/A training or supervised S/A
experience. |
| H10 |
VOCATIONAL SPECIALIST ON STAFF: The program includes at least
two staff members with 1 year training/experience in vocational rehabilitation
and support. |
Program has less than .20 FTE vocational expertise per 100
clients. |
.20-.79 FTE per 100 clients. |
.80-1.39 FTE per 100 clients. |
1.40-1.99 FTE per 100 clients. |
Two FTEs or more with 1 year voc. rehab. training or supervised
VR experience. |
| H11 |
PROGRAM SIZE: Program is of sufficient absolute size to provide
consistently the necessary staffing diversity and coverage. |
Program has fewer than 2.5 FTE staff. |
2.5 - 4.9 FTE |
5.0 - 7.4 FTE |
7.5 - 9.9 |
Program has at least 10 FTE staff. |
ORGANIZATIONAL BOUNDARIES |
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| O1 |
EXPLICIT ADMISSION CRITERIA: Program has clearly identified
mission to serve a particular population and has and uses measurable and
operationally defined criteria to screen out inappropriate referrals. |
Program has no set criteria and takes all types of cases
as determined outside the program. |
Program has a generally defined mission but the admission
process is dominated by organizational convenience. |
The program makes an effort to seek and select a defined
set of clients but accepts most referrals. |
Program typically actively seeks and screens referrals carefully
but occasionally bows to organizational pressure. |
The program actively recruits a defined population and all
cases comply with explicit admission criteria. |
| O2 |
INTAKE RATE: Program takes clients in at a low rate to maintain
a stable service environment. |
Highest monthly intake rate in the last 6 months = greater
than 15 clients/month. |
13 -15 |
10 - 12 |
7 - 9 |
Highest monthly intake rate in the last 6 months no greater
than 6 clients/month. |
| O3 |
FULL RESPONSIBILITY FOR TREATMENT SERVICES: In addition to
case management, program directly provides psychiatric services, counseling
/ psychotherapy, housing support, substance abuse treatment, employment/rehabilitative
services. |
Program provides no more than case management services. |
Program provides one of five additional services and refers
externally for others. |
Program provides two of five additional services and refers
externally for others. |
Program provides three or four of five additional services
and refers externally for others. |
Program provides all five of these services to clients |
| O4 |
RESPONSIBILITY FOR CRISIS SERVICES: Program has 24-hour responsibility
for covering psychiatric crises. |
Program has no responsibility for handling crises after hours. |
Emergency service has program-generated protocol for program
clients. |
Program is available by telephone, predominantly in consulting
role. |
Program provides emergency service backup; e.g., program
is called, makes decision about need for direct program involvement. |
Program provides 24-hour coverage |
| O5 |
RESPONSIBILITY FOR HOSPITAL ADMISSIONS: Program is involved
in hospital admissions. |
Program has involvement in fewer than 5% decisions to hospitalize. |
ACT team is involved in 5% -34% of admissions. |
ACT team is involved in 35% - 64% of admissions. |
ACT team is involved in 65% - 94% of admissions. |
ACT team is involved in 95% or more admissions. |
| O6 |
RESPONSIBILITY FOR HOSPITAL DISCHARGE PLANNING: Program is
involved in planning for hospital discharges. |
Program has involvement in fewer than 5% of hospital discharges. |
5% - 34% of program client discharges are planned jointly
with the program. |
35 - 64% of program client discharges are planned jointly
with the program. |
65 - 94% of program client discharges are planned jointly
with the program. |
95% or more discharges are planned jointly with the program. |
| O7 |
TIME-UNLIMITED SERVICES (GRADUATION RATE): Program rarely
closes cases but remains the point of contact for all clients as needed. |
More than 90% of clients are expected to be discharged within
1 year. |
From 38-90% of clients are expected to be discharged within
1 year. |
From 18-37% of clients are expected to be discharged within
1 year. |
From 5-17% of clients are expected to be discharged within
1 year. |
All clients are served on a time-unlimited basis, with fewer
than 5% expected to graduate annually. |
NATURE OF SERVICES |
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| S1 |
COMMUNITY-BASED SERVICES: Program works to monitor status,
develop community living skills in the community rather than the office. |
Less than 20% of face-to-face contacts in community. |
20 - 39%. |
40 - 59%. |
60 - 79%. |
80% of total face-to-face contacts in community |
| S2 |
NO DROPOUT POLICY: Program retains a high percentage of its
clients |
Less than 50% of the caseload is retained over a 12-month
period. |
50- 64%. |
65 - 79%. |
80 - 94%. |
95% or more of caseload is retained over a 12-month period |
| S3 |
ASSERTIVE ENGAGEMENT MECHANISMS: As part of assuring engagement,
program uses street outreach, as well as legal mechanisms (e.g., probation/parole,
OP commitment) as indicated and as available. |
Program passive in recruitment and re-engagement; almost
never uses street outreach legal mechanisms. |
Program makes initial attempts to engage but generally focuses
efforts on most motivated clients. |
Program attempts outreach and uses legal mechanisms only
as convenient. |
Program usually has plan for engagement and uses most of
the mechanisms that are available. |
Program demonstrates consistently well-thought-out strategies
and uses street outreach and legal mechanisms whenever appropriate. |
| S4 |
INTENSITY OF SERVICE: High total amount of service time as
needed. |
Average of less than 15 min/week or less of face-to-face
contact per client. |
15 - 49 minutes / week. |
50 - 84 minutes / week. |
85 - 119 minutes / week. |
Average of 2 hours/week or more of face-to-face contact per
client. |
| S5 |
FREQUENCY OF CONTACT: High number of service contacts as
needed |
Average of less than 1 face-to-face contact / week or fewer
per client. |
1 - 2 / week. |
2 - 3 / week. |
3 - 4 / week. |
Average of 4 or more face-to-face contacts / week per client. |
| S6 |
WORK WITH INFORMAL SUPPORT SYSTEM: With or without client
present, program provides support and skills for client's support network:
family, landlords, employers. |
Less than .5 contact per month per client with support system. |
.5-1 contact per month per client with support system in
the community. |
1-2 contact per month per client with support system in the
community. |
2-3 contacts per months per client with support system in
the community. |
Four or more contacts per month per client with support system
in the community. |
| S7 |
INDIVIDUALIZED SUBSTANCE ABUSE TREATMENT: One or more members
of the program provide direct treatment and substance abuse treatment for
clients with substance use disorders. |
No direct, individualized substance abuse treatment is provided
by the team. |
The team variably addresses SA concerns with clients; no
formal, individualized SA treatment provided. |
While the team integrates some substance abuse treatment
into regular client contact, they provide no formal, individualized SA treatment.
|
Some formal individualized SA treatment is offered; clients
with substance use disorders spend less than 24 minutes/week in such treatment.
|
Clients with substance use disorders spend, on average, 24
minutes / week or more in formal substance abuse treatment. |
| S8 |
DUAL DISORDER TREATMENT GROUPS: Program uses group modalities
as a treatment strategy for people with substance use disorders. |
Fewer than 5% of the clients with substance use disorders
attend at least one substance abuse treatment group meeting during a month. |
5 - 19% |
20 - 34% |
35 - 49% |
50% or more of the clients with substance use disorders attend
at least one substance abuse treatment group meeting during a month. |
| S9 |
DUAL DISORDERS (DD) MODEL: Program uses a stage-wise treatment
model that is non-confrontational, follows behavioral principles, considers
interactions of mental illness and substance abuse, and has gradual expectations
of abstinence. |
Program fully based on traditional model: confrontation;
mandated abstinence; higher power, etc. |
Program uses primarily traditional model: e.g., refers to
AA; uses inpatient detox & rehabilitation; recognizes need for persuasion
of clients in denial or who don't fit AA. |
Program uses mixed model: e.g., DD principles in treatment
plans; refers clients to persuasion groups; uses hospitalization for rehab.;
refers to AA, NA. |
Program uses primarly DD model: e.g., DD principles in treatment
plans; persuasion and active treatment groups; rarely hospitalize for rehab.
nor detox except for medical necessity; refers out some s/a treatment. |
Program fully based in DD treatment principles, with treatment
provided by program staff. |
| S10 |
ROLE OF CONSUMERS ON TREATMENT TEAM: Consumers are involved
as members of the team providing direct services. |
Consumers have no involvement in service provision in relation
to the program. |
Consumer(s) fill consumer-specific service roles with respect
to program (e.g., self-help). |
Consumer(s) work part-time in case-management roles with
reduced responsibilities. |
Consumer(s) work full-time in case management roles with
reduced responsibilities. |
Consumer(s) are employed full-time as clinicians (e.g., case
managers) with full professional status. |
