2018 outcomes report · 2. a program plan of outcomes will be developed yearly. the plan will...

2018 Outcomes Report

Introduction to the Outcomes Report Performance Indicators Review of 2018

Our Mission

Our mission is to help people with disabilities and seniors attain independence and dignity by creating opportunities for participation in the community. People in pursuit of:

• a place to live affordable housing and specialized homes • a place to learn employment and training programs • a way to get there transportation services • a place to grow and play camping and recreation programs

Think of the 4 areas of service we provide that are connected to this mission: A place to live: Affordable housing and care provided in specialized

homes, apartments and duplex living. A place to learn: Autism Services, Community Living Supports

and vocational training programs A way to get there: Transportation services A place to grow and play: Camping and recreation programs and our

LARC clubs 2018 brought change, growth and development for our agency as we expanded services in Ottawa County through a new site for Group Community Living support services, the opening of a newly built residential group home, the wide development of Senior Services and the expansion of our Vocational Services Program EVALUATING OUR IMPACT: Our Values speak to the Impact we want to provide to the individuals who receive services from Pioneer Resources. Through these Values we define the essence of the agency and its mandate to define ourselves as an agency that is devoted to dignity, respect of the individuals who receive our services.

FY 2018 Outcomes Report 1

http://www.pioneerresources.org/housing-services/

http://www.pioneerresources.org/vocational-training/

http://www.pioneerresources.org/transportation-services/

http://www.pioneerresources.org/pioneer-trails/

http://www.pioneerresources.org/housing-services/

http://www.pioneerresources.org/vocational-training/

http://www.pioneerresources.org/transportation-services/

http://www.pioneerresources.org/pioneer-trails/

OUR VALUES Choice and Self Determination – people have a right to determine

where and with whom they will live. Control – people with disabilities should have control over their living

arrangements to the extent possible. Interdependence – not independence. The word independence is

over-used. Most of us do not choose to live in isolation, but we attempt to maintain supportive, meaningful relationships.

Flexible Supports – supports should vary for each individual and reflect a combination of services, adaptations, and assistance from paid staff, family, friends, neighbors and others.

As we engage in programs of such as Skill Building, Community Living Supports, Transportation, Vocational Training, ABA Therapy, Recreational Programs or operation of licensed residential settings, defining the value of this service is a key to success. How do we evaluate our services? This challenge is one that we define throughout the year, through the input of individuals served. Satisfaction and growth are key to defining if our services are having an impact on each person’s life. At Pioneer Resources, we believe it is possible to make a difference in the lives of persons who face barriers to the exercise of choice. We believe it is our duty to try and measure our effectiveness and report our results. We recognize this is not always easy and we are dedicated to continual improvement. Because we support the rights of persons with disabilities and senior citizens to make choices, because those choices are not always articulated in a manner that can be measureable and because growth is not always rapid in providing progress, the performance measurement system we have adopted relies heavily on what the persons receiving services report and express. In other words, we want to know if the people we serve and their representatives believe we are having an impact and are satisfied that we have marched in step with their desires to participate in community to the best of their abilities. Efficiency refers to our use of resources in the pursuit of breaking down barriers. We have also chosen to measure whether we are effective. Effectiveness refers to whether or not our actions and interventions help persons served make progress toward realization of goals or choices. Data and information is entered into our electronic record system. Using tablets and the Groveware application, staff can now easily track authorizations, record goals, and provide feedback in real time on participants’ progress toward goals. Many paper records were eliminated, service billing was improved, and perhaps most important, we have been able to add the observations of staff and individuals served in order to define progress and measurements towards goal completion. MEASUREMENTS: The performance measurement system we have adopted for skill building, community living supports, and residential services encompasses the variables below. By necessity, different programs require different variables.


For each service provided by Pioneer Resources or a subsidiary, we attempt to provide a measure of efficiency and effectiveness. The following are efficiency variables we have attempted to measure. These are examples used over time. Please refer to charts elsewhere in this report for selected measures.

• Number of persons served • Revenue and expenses – the bottom line compared to budget – or

financial performance compared to inflation • The number of persons served per dollar of expense • The number of denied claims for service • Occupancy rates

Below are examples of measures of effectiveness Pioneer Resources has adopted:

• Satisfaction rates of persons served and or family members • Satisfaction rates of persons or organizations making referrals to Pioneer

Resource • Satisfaction rates of other stakeholders • Number of persons served making progress toward goals as measured by

staff

Personnel responsibilities: The daily documentation is the responsibility of the direct support professional staff working with the participants. The responsibility for monitoring and accumulating the data is held with the Program Manager and reported yearly to the Performance Improvement Specialist. Please review this report for our rates of success from the past fiscal year for each program and service. We welcome feedback and constructive criticism.

Please review this report for our rates of success from the past fiscal year. We welcome feedback and constructive criticism.


MDHHS Licensing & LRE Audits

Internal Monitoring

People Served and Family Satisfaction Surveys

Annual Outcome Program Evaluation and Management Reports Based on Service

Outcomes

Agency-Wide Annual Goals and Work Plan

Three Year Strategic Plan

Agency-Wide Assessment By Outside Consultants

Individual Plans of Service Goals and Data Collection

Program outcome goals

Evaluate Progress on Strategic Plan and Quality Indicators

Planning, Managing and Improving Program Quality and Service Outcomes

Outcome Program Evaluation

Pioneer Resources well-established program evaluation system measures mission-related service outcomes. Annual performance measures are established within each component’s outcomes goals, data is collected quarterly, and annual management reports are written based on outcome results in relation to established measures.

Internal Monitoring

The management team meets Bi weekly and will review program outcomes as well as the Board of Directors. The Management team and the Board evaluate and monitor different aspects of service through agency established quality indicators.


PIONEER RESOURCES, INC. Standard Operating Policies And Procedures

Applies to: ☐ Pioneer Arbour ☒ Pioneer House ☐ Pioneer Non-Profit Housing ☒ Pioneer Resources ☒ Pioneer Transportation

Policy Area: ☐ Health /Safety ☒ Management / General ☐ Personnel ☐ Program Operations ☐ Transportation

Subject: Program Evaluation Policy Revision Date

Number: 524 Effective Date: 9/29/18 Issue Number: 1

Purpose To establish the guidelines for the agency to evaluate the outcomes and efficiencies of services provided to individuals

All programs within Pioneer Resources will conduct an outcome evaluation process which enables the organization to regularly review the results of services and the benefits to the individuals served. This information will be presented to the Board of Directors at least annually and integrated into decision-making processes at all levels within the organization. The following expectations will be used to develop and maintain a program evaluation system for each program: 1. The program evaluation system will measure the outcomes resulting from the services provided

for all individuals served, or a representative sample of those served, as well as progress towards those ends. Areas to be measured include efficiency, effectiveness and satisfaction.

2. A program plan of outcomes will be developed yearly. The Plan will include a description of the

characteristics of the individuals served, an assessment of their gifts and needs, and development of service outcome goals and objectives. The methods and time frames for collecting, processing, reporting and disseminating the program evaluation data.

3. An outcome report will be issued yearly. This report will reflect the measures of program

effectiveness and efficiency in delivery of services, measures the satisfaction of the individuals life because of the service and an interpretation of the results. This report will be due in February of each year and will be distributed to stakeholders, family members and persons served through access on our website.

4. Program evaluation information will be used to discontinue, maintain or improve the services;

impact programmatic and administrative functions; determine the appropriateness of the services, impact our strategic planning process and confirm that the organization portrays itself and its services in an accurate manner.

5. The Executive Director will periodically review the overall adequacy of the program evaluation

system. The review will focus on the meaningfulness of the information collected and the usefulness of the information in relation to the program mission, vision and the services provided.

6. The Agency Board of Directors will be presented with the agency outcomes report yearly.


PIONEER RESOURCES

FISCAL YEAR 2018 OUTCOMES REPORT

Table of Contents Section 1: Characteristics of People Served During the Year

Total Number of People Served Individuals Served through Applied Behavior Analysis (ABA) Individuals Served through Community Connections Individuals Served through Community Living Supports Individuals Served through the Leisure and Recreation Club (LARC) Individuals Served through Residential Services Individual Served through Vocational Services Characteristics Comparison Information Section 2: Quality Improvement Plans / Goals and Objectives

Applied Behavior Analysis (ABA) Program Community Connections Community Living Supports Leisure and Recreation Club (LARC) Residential Services Transportation Vocational Services All Community Living Services Programs Section 3: Narratives and Analysis of Outcomes

Applied Behavior Analysis (ABA) Program Community Connections Community Living Supports Leisure and Recreation Club (LARC) Residential Services Vocational Services


Characteristics of People Served During the Year


Pioneer Resources Community Living Services 2018 Participant Characteristics

Total Persons Served in all Programs = 390 Age 0-17 18-30 31-45 46-65 66 yrs. + 38 84 143 105 20 Gender Male Female 236 154

Ethnicity Caucasian African American Latino Asian American

Native American

Other (Biracial)

313 64 5 7 1

Ambulation Without Assistance With Assistance

Uses Wheelchair

314 25 51 Primary Disability

Developmental Disability Mental Illness

Autism Spectrum Dual Diagnosis Other

225 27 51 76 11


Pioneer Resources Community Living Services Participant Characteristics ABA Program-Muskegon

2018 Total Number of Persons Served = 30 Age 0-5 6-10 11-15 16-17 18-21 13 15 1 1 Gender Male Female 24 6

Ethnicity Caucasian African American Latino Asian Native American Other

15 14 1

Ambulation Without Assistance With Assistance Uses Wheelchair

30 Primary Disability

Developmental Disability Mental Illness Autism Spectrum Dual Diagnosis Other

30


Pioneer Resources Community Living Services Participant Characteristics

ABA Program-Ottawa 2018 Total Number of Persons Served = 9

Age 0-5 6-10 11-15 16-17 18-21 1 1 4 2 1 Gender Male Female 9


8 1


Uses Wheelchair




9



Community Connections-Muskegon 2018 Total Number of Persons Served = 35

Age 0-17 18-30 31-45 46-65 66 yrs. + 10 17 7 1 Gender Male Female 20 15


24 10 1


Uses Wheelchair




35



Community Connections-Ottawa 2018 Total Number of Persons Served = 21

Age 0-17 18-30 31-45 46-65 66 yrs. + 4 13 4 Gender Male Female 12 9


20 1


Uses Wheelchair

18 3 Primary Disability



21


Pioneer Resources Community Living Supports Participant Characteristics

Community Living Supports (Individual)-Muskegon 2018 Total Number of Persons Served = 37

Age 0-17 18-30 31-45 46-65 66yrs. + 1 22 14 Gender Male Female 22 15

Ethnicity Caucasian African American Latino Asian American Native American Other

30 7


Uses Wheelchair

35 2 Primary Disability



35 2



Community Living Supports (Individual)-Ottawa 2018 Total Number of Persons Served = 2

Age 0-17 18-30 31-45 46-65 66 yrs. + 1 1 Gender Male Female 2


2


Uses Wheelchair




2



Leisure and Recreation Club (LARC)-Muskegon 2018 Total Number of Active Persons Served = 41



34 5 2




6 3 32



Leisure and Recreation Club (LARC)-Ottawa 2018 Total Number of Active Persons Served = 59



55 2 2


Uses Wheelchair




5 6 3 35 10



Residential 2018 Total Number of Persons Served = 52



47 3 1 1


Uses Wheelchair




44 3 1 3 1



Skill Building 2018 Total Number of Active Persons Served = 54


Ethnicity Caucasian African American Latino Asian American Native American Other (Biracial

41 10 2 1




44 3 2 5



Vocational Training 2018 Total Number of Persons Served = 50

Age 0-17 18-30 31-45 46-65 66yrs. + 29 17 3 1 Gender Male Female 32 18


37 13




33 15 1 1


2018 Participant Characteristics

Comparisons

Number of Persons Served: • 2017 - 197 • 2018 – 390 (see analysis)

Gender: • 2017 - 55% male and 45% female • 2018 – 60.51% male and 39.49% female

Ethnicity:

Ethnicity Muskegon County (per 2010 US Census)

PR Program Participants

2017

PR Program Participants

2018 Caucasian 80.0% 81.73% 80.26% African American 14.5% 16.24% 16.41% Latino 4.8% .51% 1.28% Asian American .5% 1.02% 1.79% Native American .8% - - Bi-Racial 2.8% .51% .26%

Ambulation:

• 2017 – 69% ambulation without assistance, 9% assistive device use (walker, cane) and 22% wheelchair use

• 2018 – 80.51% ambulation without assistance, 6.41% assistive device use (walker, cane) and 13.08% wheelchair use

Disability: • 2017 – 90% “Developmental Disability”, 4% “Mental Illness”, 3% “Autism

Spectrum”, 2% “Dual Diagnosis and 1% “Other” • 2018 - 57.69% “Developmental Disability”, 6.92% “Mental Illness”, 13.08%

“Autism Spectrum”, 19.49% “Dual Diagnosis and 2.82% “Other”

Analysis: Starting with 2018 forward, we are including participants in both the LARC and ABA programs when reporting characteristics of persons served during the year. This addition has almost doubled the number of people reported, and has also significantly changed the percentages in the categories of “Ambulation” and “Disability”.


Quality Improvement Plans / Goals and Objectives


Applied Behavior Analysis (ABA) Program

Objective Measures Applied To

Time of Measure

Data Source

Obtained By 2018 Goal Measured

Achievement 2019 Goal

Measure of Satisfaction Stakeholder Survey – ABA Program Families Maximize number of families who express satisfaction with the services they receive from PR

Percentage of people who express satisfaction with services being delivered.

All participants

Annually Surveys Program Manager

100% distributed 100% returned 100% satisfied

100% distributed 80% returned 87.50% satisfied 11.46% somewhat satisfied 1.04% not satisfied


Stakeholder Survey – Clinicians Maximize satisfaction of clinical team members

Percentage of expressed satisfaction with services delivered

All ABA Supports Coordinators

Annually Survey Program Manager


100% distributed 44.44% returned 100% satisfied


Measure of Effectiveness Maximize the number of program participants who meet their clinical goals

Percentage of program participants who meet their goals as indicated by treatment plan

All participants

Annually Clinical Assessments

Clinicians 80 percent of Program participants will meet at least 60 percent of skill acquisition objectives

77% of program participants met at least 60 percent of skill acquisition objectives

80 percent of Program participants will meet at least 60 percent of skill acquisition objectives


Applied Behavior Analysis (ABA) Program

Objective Measures Applied To Time of Measure Data Source Obtained By 2018 Goal Measured

Achievement 2019Goal

Measure of Efficiency Minimize days between referral and start of service to less than eight working days

Percentage of consumers meeting Outcome

All Participants FY Database Program Manager

90% of start of services will be no more than 15 working days from referral

87% of consumers started services within 15 days of referral

90% of start of services will be no more than 15 working days from referral


Community Connections

Objective Measures Applied To Time of Measure

Data Source Obtained By 2018 Goal Measured


Measure of Satisfaction Stakeholder Survey Community Connections Participants Maximize the number of consumers who express satisfaction with the services they receive from PR

Percentage of people who express satisfaction with services being delivered

All participants Annual By phone or in person

The Arc Muskegon

100% distributed 100% returned 100% satisfaction

45% Distributed 45% Returned 90% Satisfaction

100% Satisfaction. 100% Survey is reviewed with staff and develop ways to provide better service.

Stakeholder Survey - Clinicians Maximize the number of professionals making referrals who express satisfaction with services provided

Percentage of supports coordinators and others who express satisfaction

Support Coordinators, and other clinicians

Annually Electronic Survey

Program Supervisor, Program Manager or The Arc Muskegon



100% Satisfaction 80% referrals are made.

Measure of Effectiveness Maximize the number of participants who make progress toward expressed goals

Percentage of persons served whom mentors believe have progressed AND percentage of persons served who express progress

All participants Annual Service log documentation. Quarterly PCP reviews.

Program Manager/Program Supervisor. Supports coordinator.

90% of program participants will make progress with their goals

65% met 1 goal with support. 30% met at least 2 goals with support. 5% met 3 goals with support.

90% of participants Will meet at least 1 goal at a 75% success rate with support or independently.


Community Connections



Measure of Efficiency Denied Claims Minimize the number of claims denied by payers

Number of units disputed divided by all units billed

All CC claims Annually Ottawa, HW , Oceana Dispute forms and invoices

Program Manager/Supervisor and accounting staff

100% of claims paid

100% of claims were paid

100% of claims paid. 100% of documentation is accurate on service logs and authorization dates are current.

Service Access Minimize the amount of time from program acceptance to program start date

Number of days between the initial meeting and start date

All CC program participants

Annually Database, Participant files

Program Supervisor, Program Manager

100% of new participants will start within 7 days of their initial meeting

95% of new participants started within 7 days of their initial meeting

100% of new participants will start 3 to 5 days after all required paperwork is received.


Community Living Supports




Measure of Satisfaction Stakeholder Survey – CLS Program Participants Maximize number of program participants who express satisfaction with the services they receive from PR

Percentage of people who express satisfaction with services being delivered.

All participants

Annually Surveys at Person – Centered Planning meetings

Program Manager, The Arc – Muskegon, Supports Coordinators


100% distributed 54% returned 83.3% satisfied

100% Satisfied. 100% Review survey results with staff and develop ways to improve services.

Stakeholder Survey - Clinicians Maximize satisfaction of clinical team members


All CLS Supports Coordinators

Annually Survey Program Manager, The Arc Muskegon


CLS clinicians were mistakenly left off the 2018 survey list – goal not achieved


Measure of Effectiveness PCP Goals Maximize the number of program participants who meet their goals

Percentage of program participants who meet their goals with support or independently

All program participants

Annually Database Program Manager

100% of program participants will meet their goals with support or independently

2.5% accomplished goals Independently. 97.5% accomplished goals with Support.

90% of participants will meet at least 1 goal at a 75% success rate with support or independently.


Community Living Supports



Measure of Efficiency Paid/Recovered Claims

100% of claims paid.

All CLS claims

Annually HealthWest and Ottawa County Dispute forms and invoices

Program Manager and accounting staff

100% of claims paid

95% of the claims were paid. Note: Fraud case.

100% Assure accurate documentation is provided on service logs and authorization are dated correctly.

Service Access Maximum days between initial meeting and start of service, not to exceed seven

Number of days between the initial meeting and start of service


Annually Consumer files, Database

Program Manager

100% of service start dates will be no more than seven days from the initial meeting

100% of service start dates were no more than seven days from the initial meeting

At this time the Individual CLS program will not be accepting new participants. The funding does not support the program.


Residential


Time of Measure

Data Source



Measures of Effectiveness Community Integration Goals Measure the progress of staff assisting the persons served with Community Integration goals as outlined in person - centered plans (PCPs)

Percentage of PCP data sheets with documentation indicating that home staff assisted the person served with Community Integration goals

All consumers

Annually Data records maintained in group homes

Residential Supervisors

100% documentation indicating that staff assisted the persons served with Community Integration goals

99.50% documentation indicating that staff assisted the persons served with Community Integration goals

100% documentation indicating that staff assisted the persons served with Community Integration goals

Family Contact Maximize the percentage of consumers who wish to maintain contact with family and friends and assist as needed

Percentage of completed activities that were chosen, e.g. sending cards, phone calls & visits

All consumers

Quarterly Data records maintained in group homes


Maintain 100% achievement in assisting the persons served with sending cards or letters to their friends and family, phone calls, and visits

100% achievement in assisting the persons served with sending cards or letters to their friends and family, phone calls and visits

100% achievement in assisting the persons served with sending cards or letters to their friends and family, phone calls and visits

Measures of Satisfaction Resident Survey Maximize the satisfaction of the persons served


Persons served in Residential settings

Annually Survey of residents

PR or contracted agency staff

100% distributed 100% completed 100% satisfied

22 distributed 20 completed 84.09% satisfied 13.18% somewhat satisfied 2.27% not satisfied .45% no opinion



Residential


Time of Measure

Data Source



Measures of Satisfaction Stakeholder Survey - Family/Guardian Maximize satisfaction of parents/guardians


Parents or Guardians of consumers in all homes

Annually Survey of parents, guardians

The Arc Muskegon


48 distributed 20 completed 94% satisfied 6% somewhat satisfied


Stakeholder Survey - Clinicians Maximize satisfaction of clinical team members


All homes Annually Survey of SCs/RNs

The Arc Muskegon


14 distributed 2 completed 100% satisfied


Measures of Efficiency Turnover Minimize turnover, meeting or reducing the rate from previous year

Maintenance or reduction of turnover percentage from previous year

All homes Annually Employee Database


Maintain or reduce the turnover rate from 2017 (59.03%)

The turnover rate was 49.41%. Goal was achieved as written.

Maintain or reduce the 2018 turnover rate (49.41%)


Number of days between the date of program acceptance and start of service (move-in date)

All homes Annually Service Access Tracking Log

Residential Supervisors and Program Manager

100% of service start dates are within seven days of program acceptance

There were no new admissions during this reporting period.

100% of service start dates are within seven days of program acceptance


Transportation




Measure of Satisfaction Passenger Satisfaction Survey

Percentage of passengers who express satisfaction with services delivered

Persons served on Pioneer Resources buses

Annually Survey of Passengers

Transportation Director or Designee

N/A N/A 100% satisfaction with the services provided by Pioneer Resources staff

Measures of Efficiency Avoid Overtime for Full Time Staff

Maintenance or reduction of overtime percentage from previous year

Transportation Department

Annually Financial Statements


Baseline – total amount of overtime used by full time staff in 2018

N/A Maintain or reduce the 2018 amount of overtime used by full time staff

Route Review All Routes Monthly Routematch Transportation Director or Designee

Baseline – 2018 Routes efficient for mileage & time

N/A Maintain efficient routes

Measures of Effectiveness Keep Vehicle Accidents at a Minimum

Reduction in the number of accidents from previous year

All Transportation vehicles

Annually Accident Reports


Baseline – total number of accidents that occurred in 2018

N/A Reduce the 2018 number of accidents that occurred in vehicles

Staff Training Number of trainings completed versus number of required trainings

All Transportation Staff

Annually Staff training records


Baseline – 2018 total number of completed trainings versus number of required training

N/A 100% staff completion of required training


Vocational Services Skill Building Program




Measure of Satisfaction Stakeholder Survey – Skill Building Program Participants Maximize the number of consumers who express satisfaction with the services they receive from PR


All participants

Semi - Annual

Conduct written surveys and focus groups mid-year and end or year.

Program Manager + one other recorder

By end of year 97% of those surveyed will express that their experience is positive.

91% of those surveyed agreed while 9% somewhat agreed that they were satisfied with the services they receive from PR.

By end of year 97% of those surveyed will express that their experience is positive.

Stakeholder Survey – Clinicians Maximize the number of professionals making referrals who express satisfaction with progress on participant goals.

Percentage of supports coordinators and others who express satisfaction with progress on individual PCP goals

HW supports coordinators, Contract Managers and other Clinicians


Program Manager

90% of professional staff express their satisfaction with the progress achieved against PCP goals

50% of those respondents expressed satisfaction on progress toward goals while 50% had no opinion

90% of professional staff expressed their satisfaction with the progress achieved against PCP goals.

Parent/Guardian Survey – Skill Building Program Participants Maximize the number of stakeholders who express satisfaction with communication they receive from PR

Percentage of people who express satisfaction with communication

All parents and guardian representative of participants

Semi - Annual

Conduct written surveys and focus groups mid-year and end of year


90% of those surveyed will express satisfaction in the volume and quality of communication received

A parent survey was not completed to measure satisfaction in this area.

90% of those surveyed will express satisfaction in the volume and quality of communication received.


Skill Building Program

Objective Measures Applied To Time of Measure Data Source Obtained

By 2018 Goal Measured Achievement 2019 Goal

Measure of Effectiveness Maximize the number of participants who make progress toward expressed goals

Percentage of persons served whom mentors believe have progressed AND percentage of persons served who express progress

All participants

Semi - Annual

Focus group results plus progress reports prepared by mentors

Program Manager

90% of program participants will make progress with their goals

98% of program participants made progress toward their expressed goals.

90% of program participants will make progress toward their expressed goals.

Measure of Efficiency Minimize the number of claims denied by payers

Number of units disputed divided by all units billed

All SB claims Annually HW Dispute forms and invoices


100% of claims paid

100% of claims were paid

100% of claims paid

Persons served per dollar of expense

Ratio of persons served (attendance) per total expenses

The entire program

Annually *Attendance divided by expenses


2018 program will at a minimum self-sustain.

Expenses were $281,538 with 54 participants for a cost of $5214 per person.

2019 - New Goal Number of days participated in program versus number of authorized units


Number of days between the date of program acceptance and start of service


Annually Spreadsheet Program Manager

Implement a tool to measure time between program authorization & start of service

A tool to measure program authorization to start of service was not created.

Implement a tool to measure time between program referral and start of service.


Vocational Training


Data Source



Measure of Satisfaction Stakeholder Survey – Employment Services Program Participants Maximize the number of consumers who express satisfaction with the employment services they receive from PR


All participants Annual Conduct written surveys end of year.


80% of those surveyed will express that their experience is positive.

100% of respondents surveyed expressed satisfaction and choice with the services provided.

80% of those surveyed will express satisfaction in the services they are receiving.

Stakeholder Survey – Clinicians Maximize the number of professionals making referrals who express satisfaction with services provided

Percentage of supports coordinators and others who express satisfaction

MRS Counselors, Managers and other clinicians


Program Manager

90% of professional staff express their satisfaction with the program and staff.

The clinician survey provided only included Skill Building and not Vocational Training.

90% of Counselors and Clinicians express their satisfaction with the program and staff.


Vocational Training


Data Source



Measure of Effectiveness Maximize the number of participants who are enrolled in Employment Services

Physical count of individuals enrolled in services throughout 2018

All participants Annual Enrollment numbers

Program Manager

Obtain a ratio of 25% enrolled in Employment Services vs total in Skill Building Services

The ratio of those enrolled in Employment Services vs Skill Building was 92%.

Transition 25% of Skill Building participants to Vocational Training.

Program Diversity Expand the Variety of Programs Available to Participants

Number of new programs and participation in new programs

All participants Annual New programs enacted and number of individuals involved

Program Manager + 1 Recorder

Minimum 2 new programs will be enacted with at least 85% capacity of participation

2 news programs were enacted with 94% capacity of participation.

Minimum 2 new programs will be enacted with at least 85% capacity of participation.


Incident Reports and Complaints - All Programs


Data Source



Measures of Effectiveness Complaints Received By Pioneer Resources

Review and analyze for trends

All programs

Annually Database- By category

Program Managers and Supervisors

Review incident reports based on category and site and look for trends

No complaints were received by PR

Review complaints based on category and site and look for trends

Incident Reports

Monitor an Incident Report database and analyze information for trends

All homes Annually Database- By category


Review incident reports based on category and site. Compare 2018 and 2017 data. Look for trends. Share analysis with Executive Director, Board of Directors and PR staff.

See Narrative Review incident reports based on category and site. Compare 2019 and 2018 data. Look for trends. Share analysis with Executive Director, Board of Directors and PR staff.

Recipient Rights Complaints

Monitor a Recipient Rights database and analyze information for trends

All homes Annually Database- with information broken into categories


Review complaints based on category and site. Compare 2018 and 2017 data. Look for trends and take action as warranted Share analysis with Executive Director, Board of Directors and PR staff

See Narrative Review complaints based on category and site. Compare 2019 and 2018 data. Look for trends and take action as warranted. Share analysis with Executive Director, Board of Directors and PR staff


Incident Report Review


10/01/17 - 09/30/18 Incident Report Summary

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100 Aggressive Target 1 1 1 1 4 101 Attempted Suicide 0 102 Disruptive Behavior 2 1 3 2 1 3 6 5 23 103 Charting Error 0 104 Med. Error-Person 1 1 1 3 105 Treatment Error 1 1 2 106 Medication Refused 2 1 1 4 107 Med. Error-Time 4 13 7 2 4 3 33 108 Med. Not Avail. to Admin. 1 1 5 3 1 11 109 Pharmacy Error 1 2 3 110 Med Error-Med 0 111 Med Error-Route 0 112 Crime Victim 1 1 113 Death 0 114 Equipment Failure 1 1 115 Fall 4 13 4 4 3 9 1 38 116 Fire/Alarm 0 117 Inapp. Sexual Behavior 1 1 2 118 Medical Problem 5 4 1 3 11 6 5 7 42 119 Non-Serious Injury 4 18 1 6 10 18 4 1 2 9 1 74 120 Destructive Behavior 0 121 Serious Injury 1 1 1 1 1 5 122 Med Error-Dosage 1 1 2 123 Suspected Criminal Offense 0 124 ULOA 1 1 2 125 Other 1 2 1 1 5 126 Traffic Accident 2 1 3 127 Dangerous Behavior 2 1 2 1 8 14 128 Medication Error-Inventory 1 2 5 1 9

Total 18 44 10 38 5 46 36 20 2 10 42 1 9 281


Recipient Rights

Complaint Review


10/01/17 – 09/30/18 Recipient Rights Complaints

Investigations Summary

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7400, 7520 Restraint, Failure to Report X

72271 Neglect Class III X

7420 Seclusion X

7223 Abuse Class III X



7080 Services Suited to Condition/Medication X

7481 Disclosure of Confidential Information X


Complaint Summaries

Department: Lawrence

Date: 08/30/18

Code: 7400 and 7520

Category: Restraint and Failure to Report

Summary

Allegation: Staff #1 put a sheet around Resident #1 and tied it around the back of her wheelchair. Staff #1 apparently did this to keep Resident #1 from putting her hands in her mouth.

Outcome: Substantiated Not Substantiated

Department: Parkside

Date: 01/07/18

Code: 72271

Category: Neglect Class III

Summary

Allegation: Resident #1 was left in bed all of 1st shift, and did not receive brief checks

and changes. Resident #2 was told he could not get up when he wanted to. Resident

#2 hit his head on the wall and neither Staff #1 nor Staff #2 followed the proper head

injury protocol. Staff #1 was sleeping while on duty and did not complete her duties.

Outcome: Substantiated Substantiated




Department: Riverwood

Date: 08/20/18

Code: 7420

Category: Seclusion

Summary Allegation: Staff #1 put the laundry cart under the door handle of a residents’

bedroom door to keep him from coming out of his room on 3rd shift.


Department: Sheridan

Date: 03/02/18

Code: 7223

Category: Abuse Class III

Summary Allegation: Resident #1 said that a staff person yelled and swore at her.


Department: Gretchen’s Place

Date: 05/26/18

Code: 72271


Summary Allegation: The fire alarm sounded during the night. Staff #1 was scheduled

to be on duty, but was not at the home.


Department: Pioneer Plus

Date: 05/17/18

Code: 72271


Summary Allegation: The program van being observed at the gas station and a program

participant was observed unattended outside the van.





Department: Pioneer Plus

Date: 10/04/17

Code: 7080

Category: Services Suited to Condition/Medication

Summary Allegation: Staff #1 did not administer medications properly and then

falsified the medication administration sheets.


Department: Community Living Supports

Date: 07/10/18

Code: 7481

Category: Disclosure of Confidential Information

Summary

Allegation: A program participant said the CLS staff person would bring her

family or friends with her every time she was scheduled to provide CLS

services for him.


Department: Community Living Supports

Date: 05/22/18

Code: 72271


Summary

Allegation: Staff #1 left a program participant unattended, and during that

time the person engaged in appropriate behavior that ended up with him

being arrested.



Complaint Category Comparisons

0112 Crime Victim • 2018 – zero• 2017 - zero• 2016 – zero• 2015 – one• 2014 – zero

7281 Possession and Use • 2018 – zero• 2017 - zero• 2016 – zero• 2015 – one• 2014 – zero

72221 Abuse Class II, Non-Accidental Act

• 2018 – zero• 2017 - zero• 2016 – one• 2015 – two• 2014 – one

1708 Dignity and Respect • 2018 - zero• 2017 – zero• 2016 – three• 2015 – zero• 2014 - zero

7400 Restraint • 2018 - one• 2017 – zero• 2016 – zero• 2015 – zero• 2014 - zero

72222 Abuse Class II, Unreasonable Force

• 2018 – zero• 2017 - zero• 2016 – one• 2015 – zero• 2014 – zero

7080 Services Suited to Condition

• 2018 - one• 2017 - two• 2016 – three• 2015 – one• 2014 – three

7420 Seclusion • 2018 - one• 2017 – zero• 2016 – zero• 2015 – zero• 2014 - zero

72261 Neglect II • 2018 – zero• 2017 - two• 2016 – one• 2015 – zero• 2014 – zero

7081 Safety • 2018 - zero• 2017 - zero• 2016 – one• 2015 – zero• 2014 – zero

7481 Disclosure of Confidential Information

• 2018 - one• 2017 – zero• 2016 – zero• 2015 – zero• 2014 - zero

72262 Neglect II, Failure to Report

• 2018 – zero• 2017 - one• 2016 – two• 2015 – zero• 2014 – zero

7082 Humane Environment • 2018 - zero• 2017 - one• 2016 – two• 2015 – one• 2014 – two

7520 Failure to Report • 2018 – one• 2017 – one• 2016 – two• 2015 – zero• 2014 – zero

72271 Neglect Class III • 2018 – four• 2017 - two• 2016 – two• 2015 - two• 2014 – three

7223 Abuse Class III • 2018 - one• 2017 - zero• 2016 – one• 2015 – zero• 2014 – zero

7545 Retaliation/Harassment • 2018 – zero• 2017 – one• 2016 – zero• 2015 – zero• 2014 – zero

____ Failure to Follow CMHS Medication Passing Procedures

• 2018 – zero• 2017 - zero• 2016 – zero• 2015 – zero• 2014 – one

Each complaint is reviewed by program supervisors/managers, and corrective action is taken with responsible staff for substantiated allegations. Ideas to help avoid future incidents are discussed, and may include retraining in areas such as staff responsibilities, recipient rights, gentle teaching practices, behavioral supports plans and professional behavior in the workplace.


Narratives and Analysis


Pioneer Resources Applied Behavior Analysis

ABA Program 2018 Narrative and Analysis of Outcomes

Measure of Satisfaction Participant Survey For our first year of outcomes, the ABA program set a goal of 100 percent returned and satisfied respondents to our satisfaction survey. A total of 20 satisfaction surveys were sent out to consumer families of the ABA program. 16 (80 percent) were returned and 100 percent of those agreed they were satisfied with services of the program. Additionally, all respondents agreed that families were able to communicate easily with clinicians. They also agreed their child was making progress and felt informed regarding treatment plans. One respondent disagreed regarding being kept informed regarding schedule changes. All respondents stated they would recommend the center to other families. With regard to scheduling communication, it is important to note many last minute changes occur regularly. Variables that can affect last minute scheduling changes include staff call-ins, necessary productivity rates, consumer cancels and weather. Presently, scheduling changes are communicated one week in advance to families utilizing their preferred method. Communication of schedule is either given by email, text or paper copies depending on the family’s choice. Last minute changes are also communicated by these methods as soon as the changes occur. Suggested Improvement Comments included: “Communication with parents” “Maybe a little more communication between the school, ABA Center and the family” Currently, clinicians meet face to face with parents each time an assessment is completed which is a minimum of every 6 months as well as when treatment plans are updated (as needed)and are present at a minimum of 10 percent of weekly therapy services. Minimally, a clinician is communicating weekly with parents. Each treatment plan and child’s progress dictates the necessary frequency of communication above these standard intervals. Clinicians, program supervisor and program manager communicate with families based on family preference as well as clinical necessity. Other comments included: “GREAT JOB FOLKS” “Love all the staff, because they really care and love my grandson” “Love the workers” “We seem to be on tract/wonderful services & clinicians, So glad I found ABA Therapy. My son has made huge improvements” “Love our techs”


Stakeholder Survey - Clinicians A total of nine surveys were distributed and four (44.44%) were returned. Of these returned surveys, 100% of respondents were satisfied with the ABA staff in regards to communication, knowledge, participant treatment, documentation and goals and meeting the needs of the participants. 33.3% of respondents had no opinion on staff being involved in the person centered planning process or assisting participants in this process. It should be noted that one of the four respondents does not have a participant being served in the ABA program. Other factors that may have contributed to the no opinion response is in regards to the ABA process. ABA clinicians complete an additional assessment after the person centered plan is completed which only identifies that ABA services will be pursued. The individual assessment completed by clinicians determines the specific goals and outcomes that ABA participants will work towards. We will look at modifying questions number 6 and 7 in the coming year to address the assessment process for the participants in this program. This will be a more accurate measure of determining ABA staff involvement in the development of treatment goals and objectives. Measure of Effectiveness During this past fiscal year, Pioneer Resources ABA Center provided services to 39 youth from ages 2 years to 19 years old. We provided services to youth in both Muskegon and Ottawa County with a total of 30 being served in Muskegon and 9 in Ottawa County. Our measure of effectiveness was determined based on progress of the youth served. For this first year, we chose to measure the percentage of participants meeting at least 60 percent of their skill acquisition objectives. Our goal was 80 percent and our data indicates that 77 percent of our participants were successful. In analyzing this data more closely, it should be noted that the older youth or the youth that are 11 years and older make up the majority of the youth that did not hit the 60 percent success rate with regard to skill acquisition. These kids still made progress but at a lower percentage. These youth more frequently exhibited significant behavior challenges that inhibit progress to a larger degree such as significant physical aggression, property destruction and self-regulation struggles. The younger youth that did not meet this goal showed a trend of either being placed on hold or leaving the program before significant progress could be made. Additionally, when analyzing this data, we did not account for the period of time called “pairing” with the technicians. This is a time period where no demands are placed on a youth as it is clinically necessary for each technician working with a particular youth to develop a positive relationship with which to start therapy. These pairing times vary between youth and are determined based on clinical observations during sessions. We recognize that this pairing time may have also played a role in the percentage outcomes.


With the above factors in mind, we have determined to continue with the same goal for the coming year. Measure of Efficiency To begin, the ABA Center set a goal that 90 percent of consumers would start services no more than 15 working days from the date of referral. Starting services is defined by this program as either the initial “meet and greet” or the first assessment completed by the clinician. It should be noted that contact with referred consumers happens within the first week and usually consists of an introduction and setting up the first appointment. 34 consumers (87 percent) achieved this standard while 5 consumers began services after this target. Variables that affect this time frame include family cancellations, family no-shows, staff call-ins and weather. Another variable that played a role in this percentage is related to the new status of the program. Consumers were being referred at a higher rate in the beginning of the year in order to bring the program up to capacity. During that time clinician, calendars were challenged with multiple assessment and treatment plan occurrences. As program continues to increase capacity at a controlled pace, it is probable this goal will be met in the coming year.


Pioneer Resources Community Living Supports

Community Connections 2018 Narrative and Analysis of Outcomes

Characteristics

The Individual CLS program served 39 consumers with 2 of them being served in Ottawa County. Unfortunately 4 staff left our agency and with the State wide staffing crisis making it difficult to hire qualified staff, resulted in a decline in the number of participants being served. Currently we have 17 participants receiving Individual CLS in Muskegon County and 1 participant receiving services in Ottawa County. CLS was provided through Aval, Inc. which was an entity of Pioneer Resources. As of 12/15/2018 Aval, Inc. was dissolved and Individual CLS is now provided through Pioneer Resources. There was no interruption in service and our CLS staff choose to stay on as a Pioneer Resources employee, making them eligible for PTO and other benefits when/if they meet the requirements to receive benefits.

The Community Connections (Group CLS) Program served 35 participants in Muskegon County, 21 participants in Ottawa County and a new contract with Oceana County was signed and we serve 1 participant from that county.

Participants have an annual Person Centered Planning meeting and they invite who they want to attend their PCP meeting. Most generally besides their support coordinator and CLS staff they will invite family, friends and employers. Participants identify goals they want to achieve in order to live independently. The support they receive from those invited also helps assure a good PCP is in place and the goals that are identified are achievable. Participants are made aware that they can make changes to their PCP anytime by contacting their supports coordinator.

Community Living Supports provides training and/or teaching to participants. A description of service can be found in the MDHHS Medicaid Provider Manual. Examples of service provided through CLS are, meal preparation, laundry, routine and seasonal and heavy household care and maintenance, activities of daily living such as bathing, eating, dressing, and personal hygiene, shopping for food and other necessities of daily living, money management, socialization and relationship building and attendance at medical appointments. Participants can receive services in their home and/or in the community. Pioneer Resources support staff are very keen to what other needs participants have and will recommend additional services to be authorized and added as an addendum to the participants PCP. Examples of what additional needs may arise are, finding affordable housing, support through a medical issue and assuring Medicaid benefits are in order.

The same is practiced for our Community Connections programs. Participants have an annual Person Centered Plan, but this is a community based program so their goals are focused on community inclusion. Participants arrive at our 1175 E. Wesley site and prepare for the day with staff assistance and then go out into the community. Participants are in the community an average of 70% of the day. We have memberships to Fredrick Meijer Gardens and The Grand Rapids Public Museum which can be used at other museums. Participants volunteer at the Kids Food Basket, Meals on Wheels, VFW and the Muskegon Eagles #668. They attend movies, community activities, go on picnics and bowl.


Program Surveys

The Arc Muskegon completed the satisfaction surveys for both individual CLS and Community Connections. 18 Individual CLS participants completed the survey. 21 Community Connection participants completed the survey. 4 Support Coordinators also completed the survey.

The surveys are shared with staff and we focus on what improvements need to be made and how we will make that happen in order to deliver quality service as we meet the needs of the participants.

Results for Individual CLS

1. Pioneer Resources staff treat me with respect. 83.3% Agree. 11% Somewhat Agree. 5.5% Disagrees.

2. I can voice my concerns and ideas and they will be heard. 66.6% Agree. 27.7% Somewhat Agree. 5.5% Disagree.

3. Pioneer Resources staff work on my goals with me. 88.8% Agree. 5.5% Somewhat Agree. 5.5% Disagree.

4. I can reach staff if I need to make a schedule change. 88.8% Agree. 5.5% Somewhat Agree. 5.5% Disagree.

5. Staff arrive on time for our scheduled support hours. 77.7% Agree. 16.6% Somewhat Agree. 5.5% Disagree.

6. Staff are encouraging and upbeat. 72% Agree. 22% Somewhat Agree. 5.5% Disagree.

7. I have a choice in the activities I do with my worker. 83.3% Agree. 16.6% Somewhat Agree. 0 Disagree.

8. I am satisfied with the services I receive from Aval Inc./Pioneer Resources. 83.3% Agree. 11% Somewhat Agree. 5.5% Disagree.

Individual CLS

Some Comments,

Things I like about the CLS program include:

Help with accomplishing tasks, help me cook, bring me places, assisting with financial issues, enjoy getting out in the community, likes the assistance with meeting goals and likes how she cares about his best interest.

Improvements I would like to see made:

Try to be more respectful, A different staff and have more of a voice in what my goals are.


Results for Community Connections

1. Pioneer Resources staff treats me with respect. 95% Agree. 5% Somewhat Agree. 0 Disagree.

2. I can voice my concerns and ideas and they will be heard. 81% Agree. 14% Somewhat Agree. 5% Disagree.

3. I know who I can voice my concerns to. 95% Agree. 0 Somewhat Agree. 0 Disagree. 5% had no opinion.

4. Pioneer Resources staff help me as needed. 85% Agree. 5% Somewhat Agree. 5% Disagree. 5% had no opinion.

5. I have a choice in the community activities in which I participate.

38% Agree. 38% Somewhat Agree. 10% Disagree. 14% had no opinion.

6. I am satisfied with the services I receive from Pioneer Resources. 90% Agree. 10% Somewhat Agree. 0 Disagree.

Some Comments, Things I like about the Community Connection Program: The outings into the community, I love the program, really enjoy being around other people, likes going to places and taco day. Improvements I would like to see made: More patience with the participant. Feel there was some dishonesty amongst staff members at the beginning, but it’s getting better. Hire people who are physically strong enough to handle the clients, less staff turnover, better qualified staff. Participant has been coming home in a soaked brief. One occurrence of participant coming home in no brief. Support Coordinator’s results for Community Connections:

1. Do you have a consumer receiving services through Pioneer Resources Community Connections program? 75% Yes. 25% No.

2. Pioneer Resources Community Connections staff are professional in interactions with Healthwest staff and clinicians. 50% Agree. 50% Disagree


3. Pioneer Resources Community Connections program staff, coordinators or manager are available to answer questions in a timely manner. 50% Agree. 50% had no opinion.

4. Pioneer Resources Community Connections program staff treats participants with dignity and respect and offers opportunities for choice. 50% Agree. 50% had no opinion.

5. Pioneer Resources Community Connections program documentation on goals and outcomes is effective. 50% Agree. 50% had no opinion.

6. Pioneer Resources Community Connections program staff are involved in the person centered planning process when requested. 100% Agree.

7. Pioneer Resources Community Connections program assist participants in working toward their person centered goals. 50% Agree. 50% had no opinion.

8. Pioneer Resources Community Connections program meets my participants program needs. 50% Agree. 50% had no opinion.

9. Pioneer Resources Community Connections program meets my participant’s personal care needs. 50% Agree. 50% had no opinion.

Measure of Effectiveness

Participant’s progress is tracked through the Groveware data base. Staff complete a service log report each time they provide service to a participant. Part of the information collected on the service log is a narrative of the goal that was worked on and how well the participant did working on their goals. The participant may have independently completed the goal or partially completed the goal with assistance. This past year a committee worked on ways to be more accurate in collecting data in Groveware, this is an ongoing process as we continue to meet the needs of our consumers and provide the documentation required by Medicaid. Measure of Efficiency

Participant’s service logs are compared to staff’s Paycom punches weekly. This assures that all service logs have been received and current authorizations are in place. The programs are billed monthly and we also track efficiency’s by paid billings. If a claim has been denied we are notified and we complete an investigation as to why it was denied and will complete a dispute form with our findings and return it requesting payment. Another measure of efficiency is that staff are asked to work out a schedule with their participants and keep it consistent while giving the participant choice to when they receive services.


New Goals for 2019 Individual CLS

• Work with HealthWest staff to create a training for CLS staff on providing accurate documentation based on the consumer’s goals identified in their Person-Centered Plan.

• Develop educational group CLS activities that will be authorized separately from their 1:1 goals identified in their Person-Centered Plan.

Community Connections – Muskegon

• Restructure how services are provided to participants by defining the goals and needs of participants served. Example: If a participant wants to go to a volunteer site with a group that they are not usually assigned to, then we will work with them to be able to spend the day with that group.

• Utilize the “home living room” to participants by assigning a staff member to that room. This way participants can have even more choice in activities and staff can better serve participants if each room has smaller group sizes. This will also encourage program growth as a whole.

Community Connections – Ottawa

• Increase the number of participants served by 50% by attending conferences an meetings offered by CMH and other agencies that advocate for people with developmental disabilities and attend provider fairs.

• Increase the number of volunteer sites to 5 (currently have 3) by building relationships with members of the community and increasing awareness of people with developmental disabilities.

Leisure and Recreation Club – Muskegon (LARC)

• Bring in new members by attending Accessibility Expos and reaching to other community resources.

• Increase pop-up events by 20%. • Create a new membership orientation. Orientation will be within one month of becoming a

member. Leisure and Recreation Club – Ottawa (LARC)

• Increase Fridays at Compassionate Heart Ministries to 3 times a month. • Bring in new members by attending Accessibility Expos and reaching to other community

resources. • Create a new membership orientation. Orientation will be within one month of becoming a

member.


Pioneer Resources Residential Services

2018 Narrative and Analysis of Outcomes

Residential Year in Review 2018 brought several major changes to the residential department, including:

Mill Iron – New Home Our long anticipated new group home on Mill Iron was completed in August 2018. The home became licensed by the state in late September, and the ladies who previously lived at the Broadway Home moved in on October 01, 2018. Everyone seems to enjoy their new living space, especially since each person has her own bedroom!

Broadway Home – New Program The Broadway Home has received a much needed “makeover”, with new windows, flooring, kitchen cabinets, roof, siding and an attached garage. We are now partnering with LifeCircles Pace to provide housing for seniors with symptoms of dementia. Our staff are hired and trained, and we’re ready for the first people to move in, hopefully by the end of February 2019. Cindy Morden, the Riverwood and Parkside residential supervisor has stepped down from Parkside and has taken on the new Broadway program. We are excited about this new adventure!

Parkside Home - New Supervisor With Cindy Morden transferring to the Broadway Home, we were then in need of a new supervisor for Parkside. We were lucky to have several good internal candidates, and ultimately the position was offered to, and accepted by Donna Mosley. Donna started working at the Riverwood Home as a residential support staff in 1996, and she took on the added responsibilities of Home Assistant for several years. Donna then worked as a Mentor in the Community Connections program, and she took on the residential supervisor position at Parkside in October 2018.

Marcoux – New Program On October 01, 2018 Marcoux changed from a licensed, specialized group home to a non-licensed transitional living environment. The ladies who currently live at Marcoux are now working on skills needed to succeed in a more independent environment. It is our hope that the program participants are ultimately able to move into their own house or apartment. Staff are scheduled to help each person work on their individualized goals, which may include learning to ride public transportation, budgeting, shopping, cooking, cleaning, and safety skills. There are no longer staff working during 3rd shift. If one of the ladies is in need of assistance during the night, they are able to contact our on call staff via an Echo Show and talk face to face. A stove alarm was installed that will send an alert to the on call cell phone if the stovetop or oven is left on too long. A microwave that can sit on the counter was purchased because one of the ladies is unable to reach the microwave above the stove. Also purchased to help teach skills is a Pizza Pizzazz, air fryer, and panni maker.

Gretchen’s Place – New Management As of October 2018, Gretchen’s Place is now under the umbrella of “Residential Services”. Chris Pickel has taken on supervising Gretchen’s Place as well as Marcoux. We are in the process of legally dissolving the “Aval” corporation, and staff who work CLS hours are now paid by Pioneer Resources, while staff providing personal care hours (DHS chore services) are now paid by “Elite” an outside company.


Participant Characteristics

In 2018 we served a total of 52 people in our licensed group homes. There was no turnover of persons served in residential during this reporting period. Starting 2019 we will include the people who live at Gretchen’s Place in our participant characteristics information. The majority of the people we serve are between the ages of “46-65”, female, Caucasian, need ambulation assistance, and have a primary diagnosis of “developmental disability”. These characteristics vary little from year to year and this is primarily because of long-term residency. Measures of Effectiveness

Community Integration Goal Each person served by Pioneer Resources in a residential setting has set goals for themselves. These goals may include community integration, learning a new skill, spending time with friends and family, taking a vacation and participating in preferred leisure activities. Pioneer Resources residential staff assists each person served in developing and implementing their person-centered plan. To help measure our effectiveness is assisting each person we monitor the data documented by home staff which indicates that each goal was worked on as required with the person served. The 2018 goal was 100% staff documentation for each person’s goals. A compliance percentage of 99.50% was achieved. The 2019 goal is 100% documentation indicating that staff assisted the persons served with Community Integration goals. Family and Friends Contact

Both the people we serve and their family & friends seem to value keeping in contact with one another, and we believe that consistent contact with family and friends is very important. Pioneer Resources residential staff help make sure contact occurs in various ways, including assistance with making or receiving telephone calls, helping the persons served send cards and letters, and assisting with transportation for visits. To help measure our effectiveness in assisting the people we serve with family contact we document each instance of calls, visits and written correspondence, and compare that data to each person’s goal. The 2018 goals was 100% compliance in assisting the persons served with phone calls, visits and/or sending cards or letters to family and friends. A compliance percentage of 100% was achieved. The 2019 goal is to maintain 100% compliance in assisting the persons served with phone calls, visits and sending cards or letters to family and friends.


Measures of Satisfaction

We strive to provide the highest level of care to the people we support, and are always looking for ways to improve our services. One of the ways we gather information is by asking our stakeholders for their opinion on what we do well, areas of need and ideas for improvement. Residential Survey

We enlisted the assistance of The Arc to complete satisfaction surveys with a sampling of the people we serve. Surveys were completed face to face in the homes and the result were:

• 22 distributed • 20 completed • 84.09% satisfied • 13.18% somewhat satisfied • 2.27% not satisfied • .45% no opinion

The persons served in residential had many positive things to say regarding what they like about where they live, including:

• Cooking in the kitchen, improvements to the home are appreciated, like the activities at my house, I mostly get along with the roommates, I like the way our house manager conducts business with us, having some independence, the food is really good, going out for activities, all the people/friends/staff, like the 1:1 time with the staff, I like my bedroom, I like having some privacy, I like the staff, I like doing exercises and practicing with my walker.

Improvements people would like to see made include:

• To be better informed would be appreciated because we are responsible for overall decisions and some monthly expenses, I can choose when I get up and go to bed - but it has to be in the timeframe of when staff is here, less chores, the carpet needs to go, would like to have access to a bicycle - wants more physical activity, would like to work harder on my goals, would like to see improvements with the staff’s attitudes, want to have snacks when I want snacks, I don’t like (a housemate).

The 2018 goal was for 100% satisfaction with the services provided by Pioneer Resources staff; we achieved an 84.09% satisfaction rating. The 2019 goal is to achieve 100% satisfaction with the services provided by Pioneer Resources staff. Family/Guardian Survey

• 48 distributed • 20 completed • 93.94% satisfied • 6.06% somewhat satisfied


Responses to the question “what are some of the strengths of this group home and the home staff” included:

• Consistent staffing, it feels like home for (T), friendly, encouraging, clean, they share ideas among each other, good care – one on one staff outings, concern for patient, they seem dedicated to my sister’s care, happiness and well-being, they care about (J), good mix of resident, caring staff, respectful, clean environment, serve balanced meals.

Suggestions for improvements included:

• Nothing I can think of, (J) needs a little prompting to brush her teeth every day - the dentist strongly encourages this, introducing new staff, I can’t say as I’m not there every day – I’m satisfied already, continued vigilance on the part of the care givers that rules are followed by all, it is often difficult to reach someone on the resident phone, please call guardian for non-emergencies at a more appropriate hour (i.e. 10am-8pm).

Additional comments made:

• Question #1 was as “Somewhat” because I am very picky about hair and clothing - I also know that my sister has strong opinions about those also so battles have to be chosen carefully, all my comments relate to the Broadway Home – my sister recently moved to the home on Mill Iron, keep up the good care – thank you!

We appreciate the positive feedback as well as comments suggesting improvements that could be made. The survey results are reviewed by the residential team, shared with home staff, and steps are taken to put suggested improvements into effect. The 2018 goal was for 100% satisfaction with the services provided; a 93.94% satisfaction rating was achieved, with 6.06% of the responses indicating “somewhat satisfied”. The 2019 goal is 100% satisfaction with the services provided. Clinician Survey

• 14 distributed • 2 completed • 100% satisfied

A total of two (2) surveys were completed and returned by supports coordinators. There were no comments. The 2018 goal was 100% satisfaction with the services provided, and this goal was achieved. The 2019 goal is 100% satisfaction with the services provided.


Measure of Efficiency

Staff Turnover

Staff turnover for 2018 was 49.41%. While this number is still far higher than we want, it is lower than the 2017 rate of 59.03%. , which is 9% higher than in 2016. The 2019 goal is to reduce the turnover rate from 2018 (under 49.42%). Service Access

The 2018 goal was 100% of service start dates are within seven days of program acceptance. There were no new admissions during this reporting period. The 2019 goal is 100% of service start dates are within seven days of program acceptance.


Pioneer Resources Vocational Services

2018 Narrative and Analysis of Outcomes

The Vocational Services department consists of Skill Building and Vocational Training. Both programs work together as one fluid unit providing different opportunities for skill enhancement or vocational proficiency within the community. In total we served 104 persons in Vocational Services.

Our Skill Building program served 54 individuals this year. Skill Building consists of activities identified in the individual plan of service that support an individual in enhancing their personal, social, and vocational competency to live successfully in the community. They include teaching concepts such as attendance, task completion, problem solving, and safety. This is accomplished through volunteer work, teaching job related skills, career exploration, mobility training and other vocational activities related to employment. The scope of these services and supports are based on the identified needs and desires of the person served. Skill Building participants have goals toward economic self-sufficiency, work, and/or volunteering. Some of the volunteer work they participate with includes Noah’s Project, Nuveen Community Center, Step-Up Boys Home, Meals on Wheels, and the Vikings club. Participants are learning customer service skills, maintenance, organization and sorting, kitchen prep, and most importantly, they are connecting with individuals and developing relationships in the community. During their volunteer work, they are learning concepts and soft skills related to employment. Some of these skills are attitude, teamwork, problem solving, professionalism, communication skills and conflict resolution. At the beginning of the fiscal year Skill Building had one volunteer site and by the end they were actively participating in 17 volunteer sites on a regular basis.

Of the 54 persons served in Skill Building, 12 of those participants were transitioned to Vocational Training to obtain open cases with MRS. Once individuals are open and authorized for Job Placement, Job Coaches can pursue employment with them. Of the 12 participants who transitioned from Skill Building, eight of those participants became employed. Our job seekers have been placed at various small businesses throughout our community. We have strong relationships with Ryke’s Bakery, Boar’s Belly, Northside Pub, Van’s Car Wash, Reliant Cleaning, and Gary’s Restaurant, just to name a few. One of our individuals placed, Anthony Rogers, is employed by Ryke’s Bakery. He originally received part time employment as a dishwasher. After several months of success, he was offered full time employment and no longer receives Social Security Benefits. That is a true success story.

Vocational Training served 50 people. Individuals have been served through Job Placement, Job Readiness Classes, Job Coaching, ServSafe Food Handler Training, Food for Thought, Custodial Work Crew and Social Skill Development.

Measure of Satisfaction

The Arc surveyed Skill Building and Vocational Training Participants on their level of program satisfaction. 11 participants’ information was provided for the Vocational Training survey. Of those, only nine participants were reached, and five participants provided responded. The survey indicated that 100% of those surveyed felt that Pioneer Resources staff treated them with respect, supported them as needed, and provided choice and support while they applied for jobs. Additionally, 100% agreed that their quality of life improved since beginning the program and that they were satisfied with the service


that they received from Pioneer Resources. 80% of the respondents agreed that they believed their concerns and ideas will be heard and 20% somewhat agreed. When asked if they were placed in a job that fit their skills and interests, 60% of the respondents agreed while 40% somewhat agreed. 40% of participants responding agreed and 60 % somewhat agreed that the staff supported them on the job until they learned their new responsibilities. Things respondents reported to like about the Vocational Training program include: “Love the program”; “Still looking for a job but like the 1:1 assistance”; “they explain things to me”; “waiting on orientation at Reliant but I like everything”; “It is a good process – very happy with staff”; and “it’s a good program”. When asked about areas where improvement was needed, none were noted.

In the survey provided to Skill Building participants, 23 individuals were surveyed. The results showed that 100% of those surveyed felt they were treated respect. 91% agreed that their concerns and ideas were heard, and that they were satisfied with their services, with 9% somewhat agreeing. 96% agreed that they received support from staff as needed, and that they were learning useful skills in the program. 4% somewhat agreed in these two areas. When asked if he or she agreed that they had a choice in the Skill Building activities in which he or she participates, 48% agreed, 39% somewhat agreed, and 13% disagreed. 87% of those surveyed agreed to the statement, “my quality of life improved since beginning this program”, while 9% agreed, and 1% disagreed. When asked about things they liked about the Skill Building program, statements included: “I like working with others”; “I like attending 2 days per week”; “I like having fun with activities and learning”; “I like coming to Skill Building”; “I like seeing people”; “the people are cool”; “the activities”; “it’s fun”; “getting out of the house and making new friends”; “cooking”; being with friends”; “I like helping in the community at the VFW and Meals on wheels”; and “bowling”. When asked about improvements that were needed, it was suggested that other participant’s attitudes and their “ways” could be improved.

An additional survey was provided to 32 Stakeholders. We received four responses, with only three of those responding having a participant in Skill Building. All four respondent’s input was included in the results of the survey. When asked for agreement on the statement, “Pioneer Resources Skill Builder staff are professional in interactions with HealthWest staff and clinicians”; “Pioneer Resources Skill Building program staff, coordinators or manager are available to answer questions in a timely manner”; “Pioneer Resources Skill Building program staff treat participants with dignity, respect, and offer opportunities for choice”; “Pioneer Resources Skill Building program documentation on goals and outcomes is effective”; and “Pioneer Resources Skill Building program assists participants in working toward their person centered goals”, 50% responded in agreement, and 50% with no opinion. 100% agreement was given when Stakeholders were asked to agree that Pioneer Resources Skill Building program staff are involved in the person centered planning process when requested, and if Pioneer Resources Skill Building program met their participant’s personal care needs.

Measure of Effectiveness

The effectiveness of Skill Building is measured by the number of successes a participant has with meeting his or her goals. Many of the current goals are established as measurable goals, including percentages or numbers to define the goal. We see it as improvement when we see the participants getting closer to these set goals. When we are able to see that the participant is consistent in meeting or exceeding the goal, we count that as a success. Participants work with their case managers to develop


goals both quarterly and yearly, depending on the need. The percentage of participants making progress toward their stated PCP goals was 98%.

Measure of Efficiency

Skill Building had no claim disputes and 100% of claims were paid. Additional measures were introduced this past fiscal year to ensure that all face-to-face service hours were properly documented. This new system allowed us to capture all billable services and safeguard that no contracted revenue was lost.

Service Access

There was not a specific tool that measured time between program authorization and start of service for this past fiscal year since participants are unable to start program without prior authorization. Our program did not experience any delays in starting services once authorizations were received.

Program Diversity

We had two new program offerings for Vocational Training this fiscal year. One new service provided was the Social Skill Development for student’s age 16 – 26 years of age. We had 14 Pre-ETS (Pre-Employment Transition Students) funded by MRS. This was a 14 week course was taught at the Wesley Transition Center.

The other new program offering was our Custodial Work Crew. It employs two persons supported by HealthWest authorized for Supported Employment, a Crew Leader, and another personal not supported by HealthWest. The Custodial Work Crew is a paid training opportunity for participants to develop skills for competitive, integrated employment in the community.


2018 outcomes report · 2. a program plan of outcomes will be developed yearly. the plan will...

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