mental health transformation grant noms-hsmq-ras_final with edits 03-14-13.docx

7/29/2019 Mental Health Transformation Grant NOMS-HSMQ-RAS_FINAL with Edits 03-14-13.docx

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Report generated by Centerstone Research Institute, January 2013, edited 03-13-13

Mental Health Transformation Grant

My Health, My Choice, My Life

Program Evaluation Report

January 2013

Submitted by: Centerstone Research Institute

This report is based upon information gathered at baseline and discharge interviews and reflects data

gathered using three instruments: 1) the National Outcomes Measurement System (NOMS), 2) the Health and

Self-Management Questionnaire (HSMQ), and 3) the Recovery Assessment Scale (RAS).

*This word cloud was generated from letters written to Commissioner Varney by My Health, My Choice, My Life

participants after completing the program. This Word Cloud gives greater prominence to words that appeared more

frequently in these letters.


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Data Used

For this analysis, participants responses on three assessment tools were used: NOMS, Health and

Self-Management Questionnaire, and the Recovery Assessment Scale. Some of the following graphs

will include information from intake assessments only, while most will include information from a

matched pairs analysis. Matched pairs can be defined as participants that completed the intake and

discharge interviews. Throughout this report, the data that are missing (i.e. the participant refused

to answer or did not know the answer) are not included in the matched pairs analysis. Thus, theremay be some variation on the number of participants responses from question to question.

NOMS: The NOMS are completed by all participants at intake and discharge. If a participant is

unable to complete the discharge interview (i.e. cannot be located, refuses to participate, etc.) an

administrative discharge is completed for that participant. Participants with administrative

discharges are not included in the matched pairs analyses.

Assessment Total

Intake 404

Discharge 300

Admin Discharge 73Matched Pairs 300

Missing, Refused,

Dont Know 31

Health and Self-Managmement Questionnaire: The HSMQ is completed by participants at intake

and discharge. There is no administrative discharge for this assessment. Some participants did not

complete the discharge assessment because they could not be located or refused to participate in

the discharge interview.

Assessment Total

Intake 396Discharge 296

Matched Pairs 296

Missing, Refused,

Dont Know 4

Recovery Assessment Scale: The RAS is completed by participants at intake and discharge. There

is no administrative discharge for this assessment. Some participants did not complete the

discharge assessment because they could not be located or refused to participate in the discharge

interview.

Assessment Total

Intake 412

Discharge 297

Matched Pairs 297

Missing, Refused,

Dont Know 3


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Demographics

Race, gender, and age statistics

My Health, My Life, My Choice demographics mirror the state of Tennessees demographics across the

population with 80% White, 19% Black, ~1% Native American, Hispanic, Asian, or Alaskan 1. Fifty-nine

percent of participants are women, almost 41% are male and < 1% transgender. The average age of

participants is 46 years with the largest cluster of men and women falling into the 50 to 59-year-old

category.

From NOMS data:

1http://quickfacts.census.gov

1

1

1

1

2

0

3

1

2

3

20

47

188

235

1

1

3

13

29

133

164

0 50 100 150 200 250

Alaskan

Asian

Hispanic

Native Amer

Black

White

Total

Frequency

Race

Male

Female

Transgender

6

3527

48

73

38

80

7

18 21

4551

19

2 10 1 1 1 0 0 0 0

0

20

40

60

80

19 or under 20-29 30-39 40-49 50-59 60-69 70-79 over 90

Frequency

Age Group


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Functioning

Responses are coded so that larger numbers represent better outcomes. Overall participants report

statistically significant improvements between baseline and discharge in functioning, to include

controlling their own lives, getting along with their families, dealing with crisis and experiencing

fewer symptoms that interfere with their daily lives.

Significance Question/Response

.000 (highly significant) a. How would you rate your overall health right now?

.000(highly significant) b. I deal effectively with daily problems.

.000(highly significant) c. I am able to control my life.

.000(highly significant) d. I am able to deal with crisis.

.001(highly significant) e. I am getting along with my family.

.000(highly significant) f. I do well in social situations.

.000(highly significant) g. I do well in school and/or work.

.001(highly significant) h. My housing situation is satisfactory.

.000(highly significant) i. My symptoms are not bothering me.

Mental Health Status

Participants responses indicate statistically significant improvements between baseline and discharge

in their mental health status to include feeling less nervous, less hopeless, and less depressed.

Responses are coded so that larger numbers represent better outcomes (i.e., more nervousness yields a

low score and less nervousness yields a high score).

Significance Question/Response

During the past 30 days, about how often did you feel...000(highly significant ) Nervous?

.000(highly significant) Hopeless?

.000(highly significant) Restless or fidgety?

.000(highly significant) So depressed that nothing could cheer you up?

.000(highly significant) That everything was an effort?

.000(highly significant) Feel worthless?

.00

1.00

2.00

3.00

4.00

5.00

MeanScore

Baseline

Discharge


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Alcohol and Tobacco Use

There was no significant differences in tobacco use from baseline to discharge and only a modest

statistical difference in alcohol consumption (P = 0.034).

Drug Use

Almost everyone reported zero drug use at baseline therefore statistical tests cannot be used to

examine this section.

The Military Family and Deployment and Violence and Trauma sections are not included in this

analysis owing to the small number of participants reporting involvement in the military or issues

with violence and/or trauma.

Stability in Housing

There were no statistical differences between baseline and discharge in any of the housing stability

parameters.

.00

1.00

2.00

3.00

4.00

5.00

Feel Nervous Feel Hopeless Feel Restless Feel Depressed Everything Effort Feel Worthless

MeanScore

Baseline

Discharge

1.20

.18

1.02

.09

.00

.50

1.00

1.50

Tobacco Use Alcohol Use

M

eanScore

Baseline Discharge

.35 .37

1.14

.05 .09.11 .11

.82

.00 .03

.00

.20

.40

.60

.80

1.00

1.20

Nights Homeless Nights Hospital Nights Detox Nights Jail Times ER

MeanScore

Baseline

Discharge


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Living Circumstances

Most participants owned or rented their home, some lived with someone else or in a group home. Only

3 participants were homeless.

Education and Employment

The following three charts represent baseline data for education and employment. No statistically

significant differences were observed between baseline and discharge. Most of the participants were

not enrolled in an educational program and about 75% have a high school education or greater, 25%

have less than a 12th grade education.

0

20

40

60

80

100

120

140

Owned/rented Someone

else's place

Group home Transitional

living facility

Homeless Detox

Frequency

Baseline

Discharge

217

8 4

153

5 52 1 00

50

100

150

200

250

Not Enrolled Parttime Fulltime

Frequency

Enrolled in Educational Program

Females

Males

Transgender


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Additional Employment Questions

Paid at or Above Min Wage?

41

79

5

29

8

7

40

78

7

27

7

3

2

0

0

0

0

1

0 10 20 30 40 50 60 70 80 90

Less than 12th

12th Grade

Vocational Training

Some College

Bachelor's

Graduate Level

Frequency

Educational AttainmentTransgender

Males

Females

13

8

20

133

14

6

36

3

7

6

17

96

8

3

23

4

0

0

2

1

0

0

0

0

0 20 40 60 80 100 120 140

Employed Full

Employed Part

Unem Looking

Unem Disabled

Unem Vol

Unem Retired

Unem Not Looking

Other

Frequency

Employment

Transgender

Male

Female

28

3

29

6

0

20

40

Yes NoFrequency

Baseline

Discharge


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Paid Directly?

Could Anyone Have Applied For Their Job?

Arrest Summary (unpaired samples)- Sslight decrease in number of arrests observed between

Baseline & Discharge.

Assessment N Arrests PercentageBaseline 404 4 0.99

Discharge 300 2 0.66

Perception of Care

Most program participants agreed or strongly agreed that staff believe in them; provide them with

opportunities to have a voice; and staff made sure that they understand their rights. Participants also

perceived that staff respect them, helped them obtain the information that they need and participants

reported that they would recommend My Health, My Life, My Choice to friends and family members.

Look-up table for graph below

a. Staff here believe I can grow, change and recover.

b. I felt free to complain.

c. I was given information about my rights.

d. Staff encourage me to take responsibility for how I live my life.

e. Staff told me what side effects to watch out for.

f. Staff respect my wishes about who is and who is not to be given information about my treatment.

g. Staff were sensitive to my cultural background (race, religion, language, etc.)

h. Staff helped me obtain the information I needed so that I could take charge of managing my illness.

i. I was encouraged to use consumer run programs (support groups, drop-in centers, crisis phone line, etc.)

j. I felt comfortable asking questions about my treatment and medication.

k, I, not staff, decided my treatment goals.

l. I like the services I received here

m. If I had other choices, I would still get services from this agency

n. I would recommend this agency to a friend or family member.

29

2

31

4

0

50

Yes NoFrequency

Baseline

18 1217 17

0

20

Yes NoFrequenc

y Baseline


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Social Connectedness

Participants reported statistically significant improvements between baseline and

discharge in all data elements measured within the social connectedness indicator,

specifically participants improved in their ability to form friendships, enjoy people, belong

in the community and accept support from their families.

Friendships Enjoy People

Belong in

Community

Support from

Family

Significance .004 .000 .000 .000

0

20

40

60

80

100

120

140

160

180

a b c d e f g h i j k l m n

Freq

uency

Question Reference

Strongly Agree Agree Undecided Disagree Strongly Disagree

3.96

3.89

3.76

3.86

4.214.15

4.03

4.13

3.50

3.60

3.70

3.80

3.90

4.00

4.10

4.20

4.30

Friendships Enjoy People Belong in Community Support from Family

Frequency

Baseline

Discharge


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Health and Self Management Questionnaire

Disease Diagnoses

Participants most commonly reported depression, anxiety, high cholesterol, bipolar, schizophrenia and

arthritis when asked about their diagnosis. Less commonly they reported substance abuse, heart

disease and cancer.

*Includes baseline data only

60

10

136

130

77

68

49

0

25

96

15

205

170

45

118

84

0 50 100 150 200 250

Type II Diab

Type I Diab

High Blood Pressure

High Cholesterol

Obesity

Asthma

Bronch Emph COPD

Other Lung Disease

Heart Disease

Arthritis

Cancer

Depression

Anxiety

Subst Abuse

Bipolar

Schizophrenia

Frequency


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Disease Treatment

Participants had received treatment for the diseases they reported however frequencies of treatment

were lower on almost every disease reported.

*Includes baseline data only

52

10

123

112

44

55

37

1

22

71

13

192

156

33

111

78

0 50 100 150 200 250

Type II Diab

Type I Diab

High Blood Pressure

High Cholesterol

Obesity

Asthma

Bronch Emph COPD

Other Lung Disease

Heart Disease

Arthritis

Cancer

Depression

Anxiety

Subst Abuse

Bipolar

Schizophrenia

Frequency


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Disease Diagnoses by Gender (Baseline)

6

0

0

0

0

0

0

0

0

0

0

0

3

3

0

3

0

404

67

7

141

146

106

80

65

1

35

117

20

232

195

29

118

70

289

40

10

104

91

38

47

28

2

15

61

10

150

127

42

87

82

0 50 100 150 200 250 300 350 400 450

Totals

Type II Diab

Type I Diab

High Blood

Pressure

High Cholesterol

Obesity

Asthma

Bronch Emph

COPD

Other Lung

Disease

Heart Disease

Arthritis

Cancer

Depression

Anxiety

Subst Abuse

Bipolar

Schizophrenia

Frequency

Male

Female

Transgender


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Marital Status (Baseline). Most of the participants were unmarried.

Health Insurance Benefits (Baseline). Participants primarily have Tennessee Medicaid and

Medicare for their insurance provider.

Primary Care Physician

Program participants reported a highly statistically significant increase in connections with a primary

care provider between baseline and discharge (P < 0.001).

53

342

0

200

400

Married Yes Married NoFrequency

Marital Status

170

108

32

20

12

8

12

0 20 40 60 80 100 120 140 160 180

Has TennCare

Has Medicare

No Insurance

Private Insurance

Has SSI

Veteran Benefits

Other Insurance

Frequency

.65

.70

.75

.80

.85

.90

Baseline Discharge

Mean


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Health and Limitations

Current Health: Uniformly participants reported improvement in how they felt when intake responses

were compared to discharge responses.

Question: In general, would you say your health is:

Statistical Test(P= .001)

Relative Health Assessment(General Health)

Statistical Test(P= .001)

Health Limitations on Activities

Statistical tests found significant differences between baseline and discharge in four of the

questions in the chart below (identified by asterick).

Table of statistical significance (P-values). * = statistically significant.

Vigorous

Activities

Moderate

Activities

Lifting

Things

Stair

Climbing

One

Stair

Bending

over

Walk

One

Mile

Walk

Several

Blocks

Walk

One

Block

Bathing

Dressin

0.153 0.007* 0.026* 0.518 0.235 0.041* 0.312 0.114 0.012* 0.07

40

96 85

422523

67

110

5137

0

50

100

150

Poor Fair Good Very Good Excellent

Frequency

Baseline

Discharge

18

37

110

50

65

16

28

82

59

85

0 20 40 60 80 100 120

Much worse than one year ago

Somewhat worse than one year ago

About the same as one year ago

Somewhat better now than one year ago

Much better now than one year ago

Frequency

Discharge

Baseline


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Statistical Tests

Limitations as a result of physical and emotional health (paired samples). Program participants

reported fewer physical and emotional limitations associated with performing at work and they

reported accomplishing more.

1.79

2.36

2.45

2.13

2.50

2.27

2.11

2.32

2.57

2.78

1.86

2.48

2.54

2.10

2.55

2.37

2.17

2.41

2.68

2.84

.00 .50 1.00 1.50 2.00 2.50 3.00

Vigorous Activities

Moderate Activities

Lifting Things

Stair Climbing

One Stair

Bending over

Walk One Mile

Walk Several Blocks

Walk One Block

Bathing-Dressing

Frequency

Health Limitations on Activities

Discharge

Baseline

153

118

133

168

0

20

40

60

80

100

120

140

160

180

Baseline Discharge

Frequency

Accomplish Less-Physical (P= 0.001)

Yes

No

111

82

175

204

0

50

100

150

200

250

Baseline Discharge

Frequency

Reduced Work Time-Physical (P= 0.004)

Yes

No


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105123

181162

0

50

100

150

200

Baseline Discharge

Frequency

Difficulty Performing-Physical (P= 0.023)

Yes

No

141

111

144

175

0

50

100

150

200

Baseline Discharge

Fr

equency

Accomplish Less-Emotional (P= 0.005)

Yes

No

117

70

169

216

0

50

100

150

200

250

Baseline Discharge

Frequency

Limited Work-Emotional (P< 0.001)

Yes

No

137111

149175

0

50

100

150

200

Baseline Discharge

Frequency

Limited Work-Physical (P= 0.012)

Yes

No

123

81

162

205

0

50

100

150

200

250

Baseline Discharge

Frequency

Reduced Work Time-Emotional (P< 0.001)

Yes

No


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Physical and emotional interference with social activities

Question: During the past 4 weeks, to what extent has your physical health or emotional problems

interfered with your normal social activities with family, friends, neighbors or groups? Statistically

significant improvement was observed between baseline and discharge where physical health or

emotional problems interfered less with normal activities with family and friends.

Statistical Test (P< 0.001).

Question: How much bodily pain have you had during the past 4 weeks? Participants reported less

bodily pain at discharge than at baseline.

Statistical Test (P< .001).

Question: During the past 4 weeks, how much did pain interfere with your normal work (including

both work outside the home and housework)? Pain interfered with normal work less at discharge

when compared to responses collected at baseline.

Statistical Test (P= .002).

119

69

36 3923

154

72

22 22 16

0

50

100

150

200

Not at all Slightly Moderately Quite a bit Extremely

Frequency

BaselineDischarge

76

35

56 5343

23

95

4454

4435

14

0

20

40

60

80

100

None Very Mild Mild Moderate Severe Very Severe

Frequency

Baseline

123

6146 40

16

143

68

30 387

0

50

100

150

200

Not at all Slightly Moderately Quite a bit Extremely

Frequency Baseline

Discharge


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Participants reported more pep, less nervousness, more feelings of peacefulness, more energy, more

happiness and a better outlook in general when baseline responses were compared with discharge

responses.

Statistical Test: (P < 0.001).

Question: During the past 4 weeks, how much of the time has your physical health or emotional

problems interfered with your social activities (like visiting with friends, relatives, etc.)? Physical or

emotional problems less often interfered with social activities when responses from baseline were

compared to discharge.

Statistical Test(P< 0.001).

Statistical Test: (P < 0.001). Participants perception of their own health improved significantly

between baseline interview and discharge interview where participants perceived themselves

healthier and their outlook in general became more positive.

30.000

32.000

34.000

36.000

38.000

40.000

Baseline Discharge

Mean

109

40

75

15

33

13

143

55 49

11 19 9

0

2040

60

80

100

120

140

160

None of the

time

A little of the

time

Some of the

time

A good bit of

the time

Most of the

time

All of the

time

Frequency

BaselineDischarge

30.000

35.000

40.000

Baseline Discharge

Mean


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Symptoms

Participants reported statistically significant improvements when baseline responses were compared

with discharge responses. Participants reported being less affected by fatigue, pain, shortness of

breath, stress, and sleep problems.


Statistical Test (P= 0.004).

Statistical Test(P= 0.011).

52

82 82

33 36

69

116

59

17 25

0

50

100

150

None Some Moderate Considerable Severe

Frequency

Affected by Fatigue Baseline

83 7357

2745

97 87

4623 33

0

50

100

150


Frequency

Affected by Pain BaselineDischarge

136

6053

2313

153

74

34

817

0

20

40

60

80

100

120

140

160

180


Frequency

Affected by Shortness of Breath Baseline

Discharge


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Statistical Test(P< 0.001).

Statistical Test(, P< 0.001).

Smoking

Statistical Test: There were no statistical differences in tobacco use between baseline and discharge.

The chart below displays the distribution of reported use.

70 7262

4437

90 94

57

1926

0

20

40

60

80

100


Frequency

Affected by Stress BaselineDischarge

136

60 53

2313

153

74

34

817

0

50

100

150

200


Frequency

Affected by Shortness of Breath BaselineDischarge

155

10 7

93

148

4 5

73

020406080

100120140160180

Never Once or twice Weekly Daily

Frequency

Tobacco Use

Baseline Discharge


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Medicines

Statistical Tests: There were no statistical differences in the number of medications taken between

intake and discharge. However there were differences in the items on medication-related habits (see

charts and statistics below). The trend was always toward improvement at discharge.

There was a statistically significant difference between baseline and discharge in the number of

prescribed medications taken (P = 0.007).

102 96

183 190

0

50

100

150

200

Baseline Discharge

Frequency

Difficulty Remembering Meds (P= 0.58)

Yes

No

5034

235252

0

50

100

150

200

250

300

Baseline Discharge

Frequency

Stop Meds if Feeling Better (P= 0.03)

Yes

No

6135

224251

0

50

100

150

200

250

300

Baseline Discharge

Frequency

Stop Meds if Feeling Worse (P= 0.002)

Yes

No

5.72

5.31

5

5.25.4

5.6

5.8

Baseline DischargeMeanof

RxMeds

Number of Rx Meds

a

107 105

178 181

0

50

100

150

200

Baseline Discharge

Frequency

Forgot to Take Meds (P= 0.91)

YesNo


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Medical Forms

Question: How confident are you filling out medical forms by yourself?


Medical Care

Statistical Tests: Only one behavior related to seeing a medical provider improved to a statistically

significant level. Participants reported that they would more often prepare a list of questions for the

primary care provider.

78

36 4151

79

5532

49 49

101

0

50

100

150

Not at all A little bit Somewhat Quite a bit Extremely

Freque

ncy

Baseline

Discharge

0102030405060708090

100

Frequency

Ask Doctor QuestionsBaseline Discharge

0102030

405060708090

100

Fre

quency

Discuss Related Personal Problems

(P= 0.001)

Baseline Discharge

0

20406080

100120

140160

Frequency

Prepare a List of Queations for

Doctor (P= 0.025)

Baseline Discharge


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Doctor and Emergency Room Visits

Statistical Tests: There were no statistical differences between intake and discharge in number of

visits to the doctor or emergency room. There were also no statistical trends in other items in this

section (See charts below for frequency data).

26 25

257 261

0

50

100

150

200

250

300

Baseline Discharge

Frequency

Admitted to ER for Non-psychiatric

Reason YesNo

15 6

270 280

0

50

100

150

200

250

300

Baseline Discharge

Frequency

Admitted to Hospital for Non-psychiatric Reason Yes

No

17 18

267 269

0

50

100

150

200

250

300

Baseline Discharge

Frequency

Admitted to Hospital for MH

Reason YesNo

11 7

273 280

0

50

100

150

200

250

300

Baseline Discharge

Frequency

Admitted to ER for MH ReasonYesNo

9 6

276 281

0

50

100

150

200

250

300

Baseline Discharge

Frequency

Admitted to Crisis Center for MH

or SA Tx YesNo

Participants visited the doctors office

or clinic for non-psychiatric reasons an

average of 0.86 1.71 times per 6

months at baseline and 0.74 1.35

times per 6 months at discharge. The

differences between means was not

significant (P= 0.305).


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Recovery Assessment Scale

All of the 20 RAS questions showed statistically significant positive outcomes (P< .001 for all

individual questions).

Three Representative RAS Questions reflect highly statistically significant improvement when

baseline (intake) interview responses are compared with discharge interview responses.

Question Sig.

A. I have my own plan for how to stay or become well .000

B. Coping with my mental illness is no longer the main focus of my life .000

C. My symptoms seem to be a problem for shorter periods of time each time they occur .000

Higher scores represent better outcomes.

Health Behaviors Survey: The Health Behaviors Survey is designed to assess the level to which the

knowledge and skills gained during My Health, My Choice, My Life lead to behavioral changes that

can be measured based upon participants self-report. This instrument asks participants to reflect

on the past 4 weeks and is implemented at Intake and Discharge interviews. There were several

statistically significant changes observed in health behaviors related to Eating Habits: paying

attention to eating a variety of foods and serving sizes, eating foods lower in fat, reading labels,

using the plate method in choosing foods, eating at the same time each day, eating more fruits and

vegetables; Physical Activity: engaging in flexibility, strength and endurance activities. Participants

also made statistically significant improvements in confidence related to making decisions, making

an action plan, and brainstorming ideas. The bar chart below demonstrates examples of some of

these improvements.

3.75

3.41

3.46

4.13

3.79

3.82

0 1 2 3 4 5

A

B

C

Recovery Assessent Scale

Baseline

Discharge


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EATING HABITS

PHYSICAL ACTIVITY

CONFIDENCE

0 0.5 1 1.5 2 2.5

Paying attention to serving sizes

Eating food lower in fat

Eating lower sodium foods

Discharge

Intake

0 0.5 1 1.5 2 2.5

Servings of fruit eaten

Servings of vegetables eatenDischarge

Intake

0 0.5 1 1.5 2 2.5 3

Times per week engaged in flexibility

activities

Times per week engaged in strengthening

activities

Times per week engaged in endurance

activities

Discharge

Intake

0 0.5 1 1.5 2 2.5 3

Making decisions

Solving problems

Brainstorming ideas

Discharge

Intake


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Participants express high levels of satisfaction in their letters to the Commissioner. Participants

completing the DSMP report that they learned information that helps them self manage their

diabetes more effectively. They are also appreciative of learning how to increase their physical

activity.

DSMP

Intellectual Physical Environmental Social Emotional Spiritual Occupational Financial

12 11 9 4 2 1 0 0


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Similar to letters written by participants completing the Diabetes Self Management Program, the

overall experience of the Chronic Disease and Self Management Program is very positive.

Participants write about how they have improved their physical activity, have learned how to live

healthier, eat healthier, and to have a more positive impression of themselves. Participants also

attribute improvements in their social, emotional and environment to the CDSMP program

experience.

CDSMP

Physical Intellectual Emotional Environmental Social Spiritual Occupational Financial

69 64 57 41 37 23 4 1


28/29

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Fidelity Checklist

Two fidelity checklists are completed by each peer wellness coach. Overall, the CDSMP is being

implemented with acceptable fidelity.

i. Version 1 (Old CDSMP Model)Fidelity Checklist Version 1 (Old CDSMP Model)

Session 1 Session 2 Session 3 Session 4 Session 5 Session 6

Yes 151 199 190 258 180 119

No 1 1 0 1 1 0

Partial 1 1 2 2 1 0

153 201 192 261 182 119

Fidelity Checklist Version 1 (Old CDSMP Model)


Yes 98.7% 99.0% 99.0% 98.9% 98.9% 100.0%

No 0.7% 0.5% 0.0% 0.4% 0.5% 0.0%

Partial 0.7% 0.5% 1.0% 0.8% 0.5% 0.0%

ii. Version 2 (2012 CDSMP Model)Fidelity Checklist Version 2 (2012 CDSMP Model)


Yes 180 204 234 249 243 119

No 0 4 0 4 3 0

Partial 0 2 0 0 1 0

180 210 234 253 247 119


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Fidelity Checklist Version 2 (2012 CDSMP Model)


Yes 100.0% 97.1% 100.0% 98.4% 98.4% 100.0%

No 0.0% 1.9% 0.0% 1.6% 1.2% 0.0%

Partial 0.0% 1.0% 0.0% 0.0% 0.4% 0.0%

mental health transformation grant noms-hsmq-ras_final with edits 03-14-13.docx

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