BENCHMARKING FOR ORGANIZATIONAL EXCELLENCE IN ADDICTION TREATMENT

Transcription

1 BENCHMARKING FOR ORGANIZATIONAL EXCELLENCE IN ADDICTION TREATMENT Operational Benchmarks 1. Initial Access Initial Access Average number of calendar days between date of first contact and date of initial assessment appointment for addiction services during the reporting period. Exclude crisis and special programs and services. 2. Subsequent Access Subsequent Access Average number of calendar days between first assessment appointment and first addiction treatment session during the reporting period 3. Length of Stay/Utilization Level of Care Definitions: The categories below are not intended to represent all possible levels of care. Residential Short-Term Treatment is similar to ASAM Level III.5 (clinically managed, high intensity residential treatment, typically 30 days or less). Residential Long-Term Treatment is similar to ASAM Level III.3 and III.1 (clinically managed medium or low-intensity residential treatment, typically more than 30 days). Intensive Outpatient Treatment is similar to ASAM Level II.1 (9 or more hours per week). Regular Outpatient Treatment is similar to ASAM Level I (outpatient treatment, nonintensive). Bed days is defined as the total number of filled beds over the course of a reporting period. For example, if 10 beds are filled each day for one month (30 days), the total number of bed days would be 300. Residential Short-Term Treatment Adult Youth Total number of Residential Short-Term Treatment bed days provided during the reporting period Number of individuals that received Residential Short- Term Treatment during the SAME reporting period Residential Long-Term Treatment Adult Youth Total number of Residential Short-Term Treatment bed days provided during the reporting period Number of individuals that received Residential Short- Term Treatment during the SAME reporting period 1

2 Intensive Outpatient Treatment Adult Youth Total number of Intensive Outpatient Treatment visits provided during the reporting period Number of individuals that received Intensive Outpatient Treatment during the SAME reporting period Regular Outpatient Treatment Adult Youth Total number of Regular Outpatient Treatment visits provided during the reporting period Number of individuals that received Regular Outpatient Treatment during the SAME reporting period 4. Outpatient Productivity A task Group has been established to develop this metric. If you are interested in participating, please contact plefk@bpsys.org 5. Average Caseload Size of Clinical Staff Level of Care Definitions: The categories below are not intended to represent all possible levels of care. Programs and services are limited to those that principally or exclusively provide addiction treatment. Residential Short-Term Treatment is similar to ASAM Level III.5 (clinically managed, high intensity residential treatment, typically 30 days or less). Residential Long-Term Treatment is similar to ASAM Level III.3 and III.1 (clinically managed medium or low-intensity residential treatment, typically more than 30 days). Intensive Outpatient Treatment is similar to ASAM Level II.1 (9 or more hours per week). Regular Outpatient Treatment is similar to ASAM Level I (outpatient treatment, nonintensive). Residential Short-Term Treatment Adult Youth Average daily census for Residential Short-Term Treatment during the reporting period Total number of Residential Short-Term Treatment clinical FTEs (full-time equivalent staff that delivered clinical services) during the SAME reporting period Residential Long-Term Treatment Adult Youth Average daily census for Residential Long-Term Treatment during the reporting period Total number of Residential Long-Term Treatment clinical FTEs (full-time equivalent staff that delivered clinical services) during the SAME reporting period Intensive Outpatient Treatment Adult Youth 2

3 Average daily census for Intensive Outpatient Treatment during the reporting period Total number of Intensive Outpatient Treatment clinical FTEs (full-time equivalent staff that delivered clinical services) during the SAME reporting period Regular Outpatient Treatment Adult Youth Number of clients that received Regular Outpatient Treatment during the reporting period Total number of Regular Outpatient Treatment clinical FTEs (full-time equivalent staff that delivered clinical services) during the SAME reporting period 6. Average Group Size Level of Care Definitions: Intensive Outpatient Treatment is similar to ASAM Level II.1 (9 or more hours per week). Regular Outpatient Treatment is similar to ASAM Level I (outpatient treatment, nonintensive). Programs and services are limited to those that principally or exclusively provide addiction treatment. Intensive Outpatient Treatment Adult Youth Average number of clients attending per group session within the intensive outpatient setting during the reporting period Regular Outpatient Treatment Adult Youth Average number of clients attending per outpatient group session during the reporting period Clinical Benchmarks 7. Engagement/Retention, by Level of Care To be defined by Task Group. If you are interested in participating, please contact plefk@bpsys.org 3

4 8. Regular Outpatient Treatment No-Show/Cancellation Rates Service Total Appointments Scheduled During Reporting Total Number of No- Shows During Same Reporting Total Appointments Cancelled by Client During Same Reporting Total Appointments Cancelled by Provider During Same Reporting Initial Appointment for addiction service Ongoing Counseling Appointment for addiction service 9. Client Satisfaction/Perceptions of Care The client perception of care measures can be integrated into other survey tools or presented as stand-alone measures. The client should be asked to provide a rating in response to each of the statements below, using the EXACT wording provided. The response options MUST be: 5=Excellent, 4=Very Good, 3=Good, 2=Fair, 1=Poor. Wording must conform exactly to these guidelines in order to be acceptable. This measure should ideally be administered at the time of discharge in residential and structured outpatient programs and at designated intervals (e.g. monthly, quarterly, semi-annually) in outpatient programs to those that have been seen a minimum of two visits. Designated intervals should result in a sample that represents somewhere between 30% and 70% of clients served, with the lower percentage being appropriate for larger programs and the larger percentage being appropriate for smaller programs. Responses should then be averaged over all programs for the designated reporting period. Submitted data should NOT be rounded to the nearest whole number (e.g. 4.0) please provide actual mean scores (e.g. 3.87). Overall Satisfaction Average Rating Average addiction client rating in response to the statement Overall quality of care and services (5=Excellent, 4=Very Good, 3=Good, 2=Fair, 1=Poor) during the reporting period Self-Reported Outcome Average addiction client rating in response to the statement Degree to which treatment helped you to deal with your problem/complaint (5=Excellent, 4=Very Good, 3=Good, 2=Fair, 1=Poor) during the reporting period 10. Degree of Engagement with Recovery Support Services To be defined by Task Group. If you are interested in participating, please contact plefk@bpsys.org 4

5 11. Involvement of Significant Others Level of Care Definitions: The categories below are not intended to represent all possible levels of care. Programs and services are limited to those that principally or exclusively provide addiction treatment. Residential Short-Term Treatment is similar to ASAM Level III.5 (clinically managed, high intensity residential treatment, typically 30 days or less). Residential Long-Term Treatment is similar to ASAM Level III.3 and III.1 (clinically managed medium or low-intensity residential treatment, typically more than 30 days). Intensive Outpatient Treatment is similar to ASAM Level II.1 (9 or more hours per week). Regular Outpatient Treatment is similar to ASAM Level I (outpatient treatment, nonintensive). Residential Short-Term Treatment Percent of active Residential Short-Term Treatment clients that had a significant other involved in the treatment process (defined as at least one contact) during the reporting period. Significant others may include friends, relatives, clergy, or others that maintain some type of supportive relationship with the client Residential Long-Term Treatment Percent of active Residential Long-Term Treatment clients that had a significant other involved in the treatment process (defined as at least one contact) during the reporting period. Significant others may include friends, relatives, clergy, or others that maintain some type of supportive relationship with the client Intensive Outpatient Treatment Percent of active Intensive Outpatient Program clients that had a significant other involved in the treatment process (defined as at least one contact) during the reporting period. Significant others may include friends, relatives, clergy, or others that maintain some type of supportive relationship with the client Regular Outpatient Treatment Percent of active Regular Outpatient Treatment clients that had a significant other involved in the treatment process (defined as at least one contact) during the reporting period. Significant others may include friends, relatives, clergy, or others that maintain some type of supportive relationship with the client Organizational Climate Benchmarks 12. Staff Turnover Staff turnover figures should be based on personnel assigned to programs primarily or exclusively serving those with an addiction problem. Since each state has different licensure categories and service provision requirements, staff types have been collapsed into five major areas that can generalize across various states and organizational structures. These are defined below. Your data submission should include both regular employees and independent contractors. Students in paid internships, whose services are billed the same as those of any other staff member should be included in the relevant staff category. Unpaid students and volunteers, including their hours should not be included. Each staff member should be reported in only one category. If a staff person changed roles during the reporting year, include them in the beginning category. Figures are to be based on a 12 5

6 month reporting period. Do not include positions that were vacated as a result of staffing reductions/layoffs or death. Staffing Category Definitions: Administrative: Staff that provide centralized leadership and whose efforts span several programs, units, or services. Examples include CEO, quality assurance professionals, senior mangers/vice presidents, IT, HR, etc. Senior Clinical: Any staff member whose position requires a master s degree, a doctoral degree, or a medical degree and who either provides direct, billable services to clients, or who supervises the provision of such services. Staff may or may not be licensed depending upon the requirements of the particular state or payer. General Clinical: Any staff member whose position requires a bachelor s degree or certification in an addiction specialty. An example would be a certified addiction counselor. Paraprofessional Clinical Support: Any staff member who provides direct services to clients, but whose position does not require either a degree or certification. Examples include: residential assistants, job coaches, case aides, etc. Support Staff: Staff members whose efforts do not include direct client services. Examples include: receptionists, billing clerks, medical records clerks, drivers, etc. Administrative Staff Type Number of Individuals Leaving the Organization During the 12 Month Reporting Average Number of Individuals Employed/ Contracted During the SAME 12 Month Reporting Senior Clinical General Clinical Paraprofessional Clinical Support Support Staff Overall 6

7 13. Staff Morale/Perceptions Average ratings are derived from anonymous on-line surveys completed by your staff. These fields are automatically populated as staff members take the on-line survey. Item Average Rating 1. My co-workers cooperate well with one another 2. We have an adequate number of staff to do our jobs 3. My co-workers treat one another with respect Average Staffing/Co-Workers Score (Items 1-3) 4. I have recently received praise for doing my job well 5. I am proud of working here 6. There are good opportunities here to learn and grow Average Recognition and Growth Score (Items 4-6) 7. Senior leadership is committed to high quality care 8. My direct supervisor cares about me as a person 9. Leadership keeps us well-informed 10. My opinion counts here 11. This place is well-organized 12. I understand the vision and mission of this organization Average Leadership Score (Items 7-12) 13. I am satisfied with my pay 14. I am satisfied with the benefits that are made available 15.The salary and benefits that are offered here are fair Average Compensation and Benefits Score (Items 13-15) 7

8 16. I have the materials and equipment I need to do my job properly 17. The work environment is safe 18. I have ample space to do my job Average Physical Environment Score (Items 16-18) 19. The staff here provide high quality care 20. Adequate safeguards are in place to promote a safe environment 21. We are encouraged to report errors and safety problems Average Quality Score (Items 19-21) 22. I am proud to work here 23. Morale is good within my team 24. Overall, I am satisfied with my job 25. Resources are provided to deal with workrelated stress Average Satisfaction Score (Items 22-25) Overall Organizational Climate Score 14. Percent of Staff Position Vacancies (Counselors) Number of Approved, Funded Addiction Services Positions that are Currently Unfilled Total Number of Currently Filled Addiction Services Positions within Organization Certified Counselors 8

9 Financial Benchmarks The financial metrics in this section should relate to services directed primarily or exclusively to those with an addiction problem. Organizations with addiction services operating out of a broader behavioral health or human services context should make every effort to isolate and report data for addiction services only. 15. Cost per Unit of Service For each of the following addiction programs and services, provide the number of service hours or days provided for the reporting period and the direct and allocated cost to provide such services in the SAME reporting period. Allocated cost is the administrative overhead and/or indirect expense assigned to the program Level of Care Definitions: The categories below are not intended to represent all possible levels of care. Programs and services are limited to those that principally or exclusively provide addiction treatment. Residential Short-Term Treatment is similar to ASAM Level III.5 (clinically managed, high intensity residential treatment, typically 30 days or less). Residential Long-Term Treatment is similar to ASAM Level III.3 and III.1 (clinically managed medium or low-intensity residential treatment, typically more than 30 days). Intensive Outpatient Treatment is similar to ASAM Level II.1 (9 or more hours per week). Regular Outpatient Treatment is similar to ASAM Level I (outpatient treatment, nonintensive). Residential Short-Term Treatment Adult Youth Number of Residential Short-Term Treatment bed days provided in the reporting period. Bed days is defined as the total number of filled beds over the course of a reporting period. For example, if 10 beds are filled each day for 30 days, the total number of bed days would be 300. Direct and allocated cost to provide Residential Short- Term Treatment services in the SAME reporting period Residential Long-Term Treatment Adult Youth Number of Residential Long-Term Treatment bed days provided in the reporting period. Bed days is defined as the total number of filled beds over the course of a reporting period. For example, if 10 beds are filled each day for 30 days, the total number of bed days would be 300. Direct and allocated cost to provide addiction residential community-based care services in the SAME reporting period Intensive Outpatient Treatment Adult Youth Number of Intensive Outpatient Treatment visits provided in the reporting period Direct and allocated cost to provide Intensive Outpatient Treatment in the SAME reporting period 9

10 Outpatient Treatment Adult Youth Number of Regular Outpatient Treatment hours provided in the reporting period Direct and allocated cost to provide Regular Outpatient Treatment services in the SAME reporting period 16. Salaries Salaries data should be limited to staff that are principally or exclusively involved in the delivery of addiction services Staff Type Average Annual Salary During the Reporting Administrative Support Senior Clinical General Clinical Paraprofessional Clinical Support Overall 17. Administrative Overhead as a Percent of Total Expenses Management and General Expense as a Percent of Total Expenses Percent (%) This figure should be calculated on the basis of IRS Form 990 definitions. 18. Payer Mix Percent of total charges for addiction services, less all adjustments and write-offs, broken out by payer source, for the reporting period % Medicare Percent (%) 10

11 % Medicaid (Including managed arrangements) % Commercial/Private Payers (Including managed arrangements) % Government Grants/Contracts (Including managed arrangements) % Foundation/Private Grants % Other (including Self-Pay) 19. Current Ratio Calculated as total current assets divided by total current liabilities Current Ratio for the reporting period 20. Net Days in Accounts Receivable Calculated as patient AR divided by (net patient revenue divided by 365) Net Days in Accounts Receivable for the reporting period 21. Days of Cash on Hand Calculated as total unrestricted cash divided by the average daily total expense (excluding depreciation) Days of Cash on Hand for the reporting period 11