2007 ADAMH Board Results

Managing For Results Overview: In 2001, the Franklin County Board of County Commissioners mandated that every County-funded Board/Department & Commission participate in the Managing For Results [MFR] initiative as a first step toward performance based management. The intent of the MFR initiative was to allow county government to operate more like private industry by focusing on customer service and financial management. ADAMH's accountability system seeks to ensure that public resources are being used in the most efficient and effective manner to serve as many consumers as possible with quality alcohol/drug and mental health treatment and prevention services. The following is a summary of the results accomplished in 2007 based on the established MFR goals. While these results are collected and measured by the ADAMH Board in its role as the planner, funder and evaluator of behavioral health services, the results are a compilation of the hard work of hundreds of professionals working in provider contract agencies and community partner organizations. The Board recognizes and thanks all those who work in the ADAMH system of care to help Franklin County citizens with their recovery.

1. CONSUMER CARE: The purpose of the Consumer Care Line of Business is to provide quality, culturally competent mental health, alcohol and/or other drug addiction treatment and prevention services to children, adolescents, adults and older adults so they can experience recovery from their illnesses.

• The ADAMH system of care provided mental health &/or addiction treatment services to almost 3% more people (39,848) in 2007 compared to CY 2006.

The measurement and reporting of consumer outcomes serves three main purposes (a) to manage consumer care, (b) to improve the service delivery system, and (c) to account for public resources. The results showed and suggested that:

1. Treatment works! Client recovery was significant with time in treatment.
2. Clients receive quality and effective care. Clients reported high satisfaction with services received.
3. Great returns on public investment. Treatment was found invaluable as it improves the productivity of our society and reduces pain and suffering of consumers and families.

Key areas of client improvement:

• 88% of adults with severe mental illness showed improvement in at least one of the 3 major areas: reduction in symptoms distress, improvement of quality of life, and overall empowerment; 90% of consumers reported that the treatment they received helped them to deal more effectively with their problems.
• 82% of adults and older adults showed improvement in one of the 3 major areas - symptom distress, quality of life and satisfaction with financial situation; 90% of consumers reported the treatment helped them to deal more effectively with their problems.
• 75% of children and adolescents receiving treatment showed improvement in two of the following areas: reduced problems, improved functioning and hopefulness; 92% of adolescents and 85% of parents reported that the treatment was effective.
• Approximately 87% of adults receiving alcohol and other drug treatment showed improvement in the majority of the problem areas (4 out of 7): health, employment, alcohol use, drug use, family/social relationships, criminal justice, and psychiatric problems. More than 88% of adults reported that treatment was effective.
• 100% of ADAMH Work groups/policy committees (nine in total) were rated by participants as producing consumer-centered outcomes.
• 100% of persons with a diagnosed mental illness referred and accepted [11/17] into the PATH DRC Program [Program to Assist in Transition from Homelessness - Dept. of Rehab & Corrections] were housed within 1 day of release from prison.
• 97.6% of consumers [1091] who were provided affordable housing through Community Housing Network [CHN] maintained the same residence for at least one year.
• More than 56,665 youth received prevention services and 92% reported increased awareness or positive behavior change after participating in the program.
• More than 45,425 adults received prevention services in and 81% reported increased awareness or positive behavior change as a result of participating in the program.

2. SYSTEM OF CARE PLANNING & EVALUATION: The purpose of the System of Care Planning & Evaluation Line of Business is to provide strategic plans for network capacity and access so that consumers' needs and demands for good quality, diverse and culturally competent treatments and services are adequately met.

• Conducted 33 reviews of agencies with ODMH and ODADAS Medicaid claims during SFY 06 and issued timely findings reports.
• Completed 1021 housing inspections to ensure that homes of consumers with Severe and Persistent Mental Illness [SMI] met minimum fire and life safety standards and that those consumers are receiving appropriate services; 96% of inspected homes passed Fire and Life Safety inspections on the first visit.

After successful passage of the levy in the fall of 2005, the ADAMH Board kept its promise to the community to create additional service capacity in targeted areas of need. The Board instituted a Request for Results (RFR) process, which outlined specific programmatic and budgetary specifications, and contracted agencies competed for additional funding. Starting in January 2007, providers receiving the new funds implemented programs targeting a variety of target populations with identified behavioral health care needs.

Some highlights from the newly created programs include the following:

Servicing Children and Youth with Treatment Needs:

• A Youth Crisis Team was funded as a partnership between NetCare Access, Nationwide Children's Hospital and the OSU Medical Center. In CY 2007, the newly formed Youth Crisis Team served 1821 youth. These services are available to any Franklin County resident under the age of 18 who is experiencing a behavioral health care crisis, and their families.
• Established an agreement with the Ohio State University social work field placement office to have a bi-lingual graduate student intern for the 2006-2007 academic years to assist with various cultural competency projects at the Board.
• ADAMH and Franklin County Children's Services (FCCS) joined to fund an intensive treatment, daily support and life skills development program at North Central Mental Health Services, Inc. for youth who need significant levels of assistance to transition from multiple foster care placements and extended residential treatment center stays to independent living. The youth referred by FCCS have severe and persistent mental illness and are likely to need ongoing medication and treatment as adults. During the first year, 43 youth were enrolled in this treatment model.
• Three prevention/early intervention programs were funded to target children at risk for dropping out of school due to poor attendance, disciplinary actions, and failing grades at the Westerville City Schools, Hilliard, Hamilton Local, Canal Winchester, Reynoldsburg, Grandview City and Southwestern City Schools. In CY2007, 758 children and adolescents were served by these new programs.
• Coordinated and funded a Somali youth-based program at Mifflin Middle School International Welcome Center. This program is operated by Rosemont Center and the Communities in Schools Program - in collaboration with the ESL program at the school. The program is designed to support teachers who have been struggling with the behavioral needs and issues of Somali students who are new to this country. Recent reports indicate the program is in high demand and is successful in working with youth and their families. In addition, the Board applied and received a grant award for $35,000 from the Columbus Foundation that will allow a researcher from The Ohio State University (Human Ecology) to evaluate the effectiveness of this innovative initiative.

Servicing Adults with Treatment Needs:

• Three providers were funded with additional levy funds to create more capacity to treat persons who have experienced psychological trauma. Dublin Counseling Center, Northwest Counseling Services, and Southeast Inc. treated 470 additional consumers in need of trauma treatment. Southeast's program has a particular focus on the Somali population. All three of the trauma treatment programs are utilizing evidence based treatments that produce improved outcomes.
• Three providers were funded to increase the system's capacity to meet the behavioral health care needs of older adults. Concord Counseling Center, Northwest Counseling Services, and Maryhaven for Older Adults worked with 276 older adults in a variety of settings. All of the programs implemented focused on primary health care and behavioral health care integrated models of care in their approach to this population.
• A specialty probation treatment team was funded at Southeast, Inc to provide services to persons on probation under the supervision of the Franklin County Municipal and Common Pleas Courts to avoid re-involvement with the criminal justice system. Ninety-six (96) adults were served last year.
• Served an additional 267 adults with medically assisted opiate treatment programs at CompDrug and Maryhaven utilizing capacity expansion funds.

Supporting Consumer Recovery:

• The Consumer Operated Center, now named the PEER (Peers Enriching Each others' Recovery) Center, has been in operation since January 1, 2007 and is open from 7 a.m. to 11 p.m. every day, including holidays. The PEER Center provided services to 807 unique visitors in the first 13 months of operation. The Center provides socialization, educational opportunities and employment for persons with Severe and Persistent Mental Illness [SMI]. This new program is focused on assisting consumers in their own recovery, as well as providing peer support to others in need.

Supporting System/Community Planning:

• The ADAMH System Training Institute at Maryhaven was developed to provide educational opportunities on behalf of staff persons working for ADAMH Board contract providers. In CY2007, 408 individuals participated in educational training sessions which included, but was not limited to, evidence-based treatment and prevention models, CPR, ethics in the workplace and cultural competency.
• An additional 1282 individuals received education about suicide prevention through the Franklin County Suicide Prevention Coalition and 74 additional suicide survivors received outreach packets to assist in their grieving and recovery process.
• ADAMH initiated a comprehensive evaluation and planning process with its community partners to address the increasing demand for ADAMH-funded adult psychiatric hospitalization at state Behavioral Healthcare Organizations (BHOs - previously known as state hospitals). We continue to develop and implement strategies and tactics to address these community challenges and will report back next year on the results of those new efforts.

Community Partnerships:

• The Franklin County Children Services Board and the ADAMH Board of Franklin County signed an agreement to create a partnership that will focus on reducing the number of children in FCCS custody that are being treated in out-of-county institutions. This partnership will also result in improved multi-disciplinary planning on behalf of children in both systems of care.
• Partnered with Judge Scott VanDerKarr, the Franklin County Municipal Court and ADAMH-funded mental health treatment providers to continue the Mental Health Court Specialty Docket. The target population is offenders with criminal charges that have concurrent severe and persistent mental health issues. The program currently has 57 active participants and 31 individuals were successfully discharged in CY2007. The Mental Health Court Specialty Docket saves the County approximately $268,338 per year in jail days and costs associated with court summons.
• The ADAMH Board began a partnership with the Ohio Department of Rehabilitation and Corrections, the Ohio Department of Mental Health, COVA and Columbus Area, Inc. to implement a forensic peer specialist program that assists individuals who have been in the criminal justice system who also have Severe and Persistent Mental Illness [SMI] to successfully transition to the community. Will report initial results at the end of 2007.
• Seven schools in Franklin County were recognized by Columbia University and the Ohio Suicide Prevention Foundation as Teen Screen sites. Teen Screen is a screening tool that assists in identifying children who are at risk for suicide. All of the children identified as at-risk are referred for immediate professional interventions.
• Secured grants from public & private sources to the ADAMH System of care resulted in $1,000,751 in additional funds for increased programs and services targeting populations in need. ADAMH provided either technical assistance &/or primary grant writing services to secure these funds.

Community Education Activities:

• ADAMH's community relations efforts included meeting with or giving presentations at 77 different organizations or key stakeholders, such as Columbus City Council, The Ohio Senate, The Ohio Hispanic Coalition, ACRA Somali Group and Ephesus Seventh Day Adventist Church, with the help of ADAMH and provider staff members, to convey ADAMH educational materials and targeted messages.
• Continued a paid public education campaign with the launch of ADAMH's anti-stigma campaign on local television stations WBNS 10-TV, WCMH NBC-4, and Time Warner Cable, airing 472 TV ads on programs such as CSI Miami, The Oprah Winfrey Show and the Today Show. Also with WCMH NBC-4, ADAMH featured three Web site banner ads on www.nbc4i.com.
• Launched a supplemental education campaign on local radio with ads airing on WOSU 820 AM and WXOL 1550 AM (Radio Sol) with 636 radio spots; fifteen billboards were purchased throughout Franklin County with key educational messages.
• Proactively pitched 469 stories resulting in 129 stories in print, radio and television media outlets, almost 15% of which focused on anti-stigma efforts to align with ADAMH's paid advertising campaign.
• ADAMH's Web site continued to draw visitors, resulting in more than 6,900 monthly visitors.
• "Hosted ADAMH's Annual Meeting celebration at the Columbus State Community College's Center for Workforce Development, attended by more than 200 elected officials, provider staff and community guests. Highlights of the event included Keynote Speaker Commissioner Mary Jo Kilroy. Also, three awards were presented, along with a resolution honoring the late Tom Ramseyer, long-time executive director at the House of Hope:
  • Randall M. Dana Award of Excellence awarded to Barbara Merritt, House of Hope.
  • Barry Mastrine Award awarded to Linda Jakes, Concord Counseling Services.
  • Art Lynn Consumer & Family Advocate Award awarded to Chris Frezner.
• Distributed an e-newsletter called "ADAMH E-news" in February, May, August and November to approximately 3000 community members.

3. ADMINISTRATIVE AND LEADERSHIP SERVICES: The purpose of the Administrative/Leadership Support Services Line of Business is to provide community outreach and awareness, human resources, facility and equipment, financial management, and information support Services to citizens, and ADAMH Board of Trustees and staff so they can achieve their goals and fulfill the Board's mission.

• ADAMH Staff donated $11,452 to the Franklin County Combined Charitable Campaign this year, which was $1,452 over our goal. It is worth noting that of the 37 county agencies involved in the Combined Charitable Campaign, ADAMH was one of only twelve that reached their fund-raising goal. Of the twelve that attained their goal, ADAMH had the highest contribution per employee (approximately $200 per employee!). In total, the 2007 Combined Charitable Campaign raised over $320,000 for area charitable organizations.
• ADAMH took advantage of both county sponsored e-learning and onsite classroom instruction. The migration from paid commercial training vendors to the free county trained saved approximately $2300.

Facility Efficiencies:

• 92% of ADAMH's staff rated the quality of facility services as either satisfied or very satisfied.
• 98% of the regularly scheduled facility projects and preventative maintenance activities were successfully completed on-time.
• 100% of all emergency building repairs were completed within 1.5 business days, resulting in no interruption in staff functioning in a safe and healthy environment.
• 100% of the identified major maintenance items at the Engagement Center, which serves publicly inebriated men on Maryhaven's campus, were completed on time.

Business and Financial Services Results:

• In partnership with providers, 41,149 retro Medicaid claims were completed translating into the collection of $2,344,778 in retroactive Medicaid federal matching funds. This "hands on" effort created funding for services for an additional 1,151 uninsured consumers.
• Paid 1.5 million behavioral healthcare claims totaling $96.7 million to 202 providers; 98.7% of the funds were paid within 60 days.
• Completed more than 88% of data report requests by the requested due date.
• Expanded the capacity for secure transfer of clinical records between Netcare Access, the lead SMI providers, Twin Valley Behavioral Health and the Franklin County Jail, which results in improved care coordination for consumers with severe mental illnesses who are in crisis, are hospitalized or are in jail.
• Reduced computer hardware, software and administration costs through the expanded use of thin client technology.
• Provided easy access to 15 automated System Quality Indicator and other reports that included the ability to analyze them for various diversities.
• Successfully assisted all Franklin County providers with the timely implementation of the new HIPAA requirement to submit their claim files with their National Provider Identifier [NPI].
• Providers received essential billing information in an average of 3.4 business days and 12,024 new clients were manually enrolled into MACSIS. In addition to the new manual enrollments, 8,421 member records were manually updated within 1 business day; more than 22,000 financial eligibility records were created and manually updated to ensure correct claims payments.
• Manually processed 1,108 batches of claims corrections in an average of 3.5 business days, in order to continually increase the accuracy of provider reimbursement and speed with which federal matching funds for Medicaid is recouped.
• Financial projections provided accurate decision making tools to ADAMH Board of Trustees and Senior Management. The 2007 Revenues and Expenditures were within 1% of the 10-Year Levy Model.
• More than 98% of the 510 financial reports developed were published in a timely fashion.
• Nine new financial reports were developed during 2007 to help ADAMH staff monitor Provider performance and also help Providers manage their business more effectively. The new reports were generated after each claim run (26 cycles), affording all stakeholders timely access to this information.
• Entered providers' rates into MACSIS within 4 days of approval, allowing timely and accurate reimbursement for services.