Notes from Individual Care Grant Data Work Group

November 21, 2013

  1. It was agreed that data needed to be collected regarding 1) child and family outcomes 2) services 3) systems. All data needs to be timely in order to guide decisions at all system levels, and improvements.
  2. Basic descriptive data that should be collected (and some of this is currently being collected) is: number of youth in the program; expenditures per youth and total expenditures for both RTC and community based services per year; clinical diagnosis of all program recipients; number of applications submitted; number and timeliness of reviews; number of approvals and denials; current residential providers and number of ICG recipients in setting; length of stay in residential per youth and overall average days in residential stay; movement between community based grants to residential grants and vice versa; denials of community based service requests and reason; and, number of terminated grants. This data should be gathered monthly and distributed for review.
  3. The work group also discussed the importance of DMH having information from stakeholders regarding their satisfaction with ICG services. At present the ICG administration does not have information on what community services that have been approved are actually being provided. This makes it very difficult to monitor and improve the CB ICG system.
  4. Short-term recommendations to make more immediate changes to the ICG system started and will continue at the next meeting. A concern is that if data is not available to understand the problems in the current system structure there is a significant likelihood that changes in the Rule will not address these underlying systematic issues.*
  5. The Work Group recommends establishment of an outcome tracking system for youth after they leave the Individual Care Grant (ICG) program and those youth who have been denied an ICG.
  6. The Work Group reviewed current available information as presented orally by Department of Human Services Division of Mental Health (DMH) staff: Application data includes number of applications completed and number accepted. In FY 13 90 youth were enrolled in the ICG program at an overall cost of ?? (Need to check DMH to clarify this; only 90 youth in the whole program? ) Current youth data includes age, length of stay and preparation for transition. Youth with an ICG obtained an average score of 26.7 on the Columbia scale (parent version) with a decline to 22.1 after 90 days. On the Ohio scale initial average score of 34.7 dropped to 28.9 at 90. The overall average scores for children and youth served by DMH contract providers went from 25.3 to 21.5. This data indicates that youth are benefitting from the ICG program and youth with high levels of need are being served.
     
    A discussion ensued about how to use data regarding individual care decisions. While improvements do not in and of themselves indicate readiness for a lesser level of care, data may be one important factor to consider in making that decision. The Work Group felt strongly that data and decisions needed to focus on functioning across multiple domains, rather than specific diagnosis or symptoms. Symptom change is relatively easy to make; whereas functioning change is both more difficult to achieve and more important overall. Community and family supports need to be considered when making individual care decisions-some communities have more supports to offer than others. The Work Group would recommend tracking levels of functioning with not only the place of service but the specific service mix. This would help clarify what specific services are working and assure continuity between community based and residential service planning. It also would provide important data regarding what services are correlated with the highest levels of improvement and help identify what additional services might be needed.
  7. The next meeting was set for December 19th from 11:00-12:30. A report will be due to DMH following that meeting.