CRITERION
|
RATINGS / ANCHORS |
SCORE
1 thru 5
|
| H1 |
SMALL CASELOAD: client/provider ratio of 10:1.
|
50 clients/clinician or more.
|
35 - 49 |
21 - 34 |
10 clients/clinician or fewer
|
11 - 20 |
| 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 contacts in reporting week.
|
10 - 36%. |
37 - 63%. |
90% or more clients show contact with > 1 staff member in 1 week.
|
64 - 89%. |
| 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.
|
Program meets at least 4 days/week and reviews each client each time,
even if only briefly.
|
At least twice/week but less often than 4 times/week.
|
| 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 provides services at least 50% time. |
Supervisor normally provides services between 25% and 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.
|
Less than 20% turnover in 2 years. |
20-39% 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% |
Program has operated at 95% or more of full staffing in past 12 months. |
80-94% |
| 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. |
.40-.69 FTE per 100 clients. |
.40-.69 FTE per 100 clients. |
At least one full-time psychiatrist is assigned directly to a 100-client
program.
|
.70-.99 FTE per 100 clients.
|
| 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. |
Two full-time nurses or more are members of a 100-client program.
|
1.40-1.99 FTE per 100 clients. |
| 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. |
Two FTEs or more with 1 year S/A training or supervised S/A experience. |
1.40-1.99 FTE per 100 clients. |
| H10 |
VOCATIONAL SPECIALIST ON STAFF: the program includes at least one staff
member 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. |
Two FTEs or more with 1 year voc. rehab. training or supervised VR experience. |
1.40-1.99 FTE per 100 clients. |
| 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 |
Program has at least 10 FTE staff. |
7.5 - 9.9 |
| 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. |
The program actively recruits a defined population
and all cases comply with explicit admission criteria.
|
Program typically actively seeks and screens
referrals carefully but occasionally bows to organizational pressure.
|
|
| 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 |
Highest monthly intake rate in the last 6 months no greater
than 6 clients/month. |
7 - 9 |
|
| O3 |
FULL RESPONSIBILITY FOR TREATMENT SERVICES: in addition to
case management and psychiatric services, program directly provides counseling
/ psychotherapy, housing support, substance abuse treatment, employment,
and rehabilitative services. |
Program provides no more than case management and psychiatric
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 all five of these services to clients.
|
Program provides three or four of five additional services
and refers externally for others.
|
|
| 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 24-hour coverage.
|
Program provides emergency service backup; e.g., program
is called, makes decision about need for direct program involvement.
|
|
| O5 |
RESPONSIBILITY FOR HOSPITAL ADMISSIONS: program is involved
in hospital admissions.
|
Program has no involvement in fewer than 5% decisions to
hospitalize. |
5 - 34% of admissions are initiated through the program. |
35 - 64% of admissions are initiated through the program. |
95% or more admissions are initiated through the program. |
65 - 94% of admissions are initiated through the program.
|
|
| 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 done in cooperation
with the program. |
35 - 64% of program client discharges are done in cooperation
with the program. |
95% or more discharges are planned jointly with the program
|
65 - 94% of program client discharges are done in cooperation
with the program. |
|
| O7 |
TIME-UNLIMITED SERVICES: Program never 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.
|
All clients are served on a time-unlimited basis, with fewer
than 5% expected to graduate annually.
|
From 5-17% of clients are expected to be discharged within
1 year. |
|
| S1 |
IN-VIVO SERVICES: program works to monitor status, develop
community living skills in vivo rather than in office.
|
Less than 20% time in community. |
20 - 39%. |
40 - 59%. |
80% of total service time in community |
60 - 79%. |
|
| S2 |
NO DROPOUT POLICY: program engages and retains clients at
mutually satisfactory level.
|
Less than 50% of the caseload is retained over a 12-month
period.
|
50- 64%. |
65 - 79%. |
95% or more of caseload is retained over a 12-month period.
|
80 - 94%. |
|
| S3 |
ASSERTIVE ENGAGEMENT MECHANISMS: as part of assuring engagement,
program uses street outreach, as well as legal mechanisms (e.g., representative
payees, probation/parole, OP commitment) as indicated. |
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 demonstrates consistently well-thought-out strategies
and uses street outreach and legal mechanisms whenever appropriate.
|
Program usually has plan for engagement and uses most of
the mechanisms that are available. |
|
| S4 |
INTENSITY OF SERVICE: high total amount of service time as
needed. |
Average of less than 15 min/week or less per client.
|
15 - 49 minutes / week.
|
50 - 84 minutes / week.
|
Average of 2 hours/week or more per client.
|
85 - 119 minutes / week. |
|
| S5 |
FREQUENCY OF CONTACT: high number of service contacts as
needed.
|
Average of less than 1 contact / week or fewer per client.
|
1 - 2 / week. |
2 - 3 / week. |
Average of 4 or more contacts / week per client.
|
3 - 4 / week. |
|
| S6 |
WORK WITH 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.
|
Four or more contacts per month per client with support system
in the community.
|
2-3 contacts per months 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.
|
Clients with substance use disorders average fewer than 3
minutes / week in substance abuse treatment.
|
From 3 to 9 minutes / week.
|
From 10 to 16 minutes / week.
|
Clients with substance use disorders spend 24 minutes / week
or more in substance abuse treatment.
|
From 17 to 23 minutes / week. |
|
| 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% |
50% or more of the clients with substance use disorders attend
at least one substance abuse treatment group meeting during a month.
|
35 - 49% |
|
| 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 fully based in DD treatment principles, with treatment
provided by program staff.
|
Program uses primarily DD model: e.g., DD principles in treatment
plans; persuasion and active treatment groups; no hospitalization for rehab.
nor detox except for medical necessity; refers out some s/a treatment.
|
|
| 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) formally assist in provision of direct services
(e.g., co-lead groups).
|
Consumer(s) are employed as clinicians (e.g., case managers)
with full professional status.
|
Consumer(s) work in case management roles with reduced responsibility. |
|
