Four Corners Four Corners Community Behavioral Community Behavioral Health CenterHealth Center

Presented byPresented by

Aralias ResearchAralias ResearchRyan Jensen, Marcus Waite, and Nick BellRyan Jensen, Marcus Waite, and Nick Bell

Brief History of FCCBHBrief History of FCCBH

• Provides mental health and substance abuse services to adults, youth, and children in Carbon, Emery and Grand Counties

• Serves Southeastern Utah since 1972 • Staff includes: psychiatrists, psychologists,

licensed clinical social workers, licensed professional counselors, licensed substance abuse counselors, registered nurses, advanced practice registered nurses, case managers, family advocates and more

Objectives of Research ProjectObjectives of Research Project

• Draw comparisons to past Medicaid studies (specifically, Maximus 2002 survey research explaining 2002 numbers) to respond to the question, “How does client satisfaction now compare to 2002 client satisfaction?”

• Determine in what areas of service FCCBH is doing well

• Determine in what areas FCCBH can improve its service

Methodology and Methodology and Sample SizeSample Size

•Exploratory Research

•Secondary Research

•Primary Research

•Sample Size

Exploratory Research MethodsExploratory Research Methods

Discussed with FCCBH staff via Marilyn Mitchell to obtain direction and objectives for the project

- Built/revised previous Medicaid questionnaire

Secondary Research Secondary Research MethodsMethods

• Examined previous Medicaid survey– Used as a template for performing

revisions and drawing comparisons

• Studied both Maximus 2002 and GMP surveys and results– Determined categories for

comparisons from Maximus 2002 survey

– Determined low scoring or problem questions within Maximus 2002 survey

Primary Research Methods Primary Research Methods and Sample Sizeand Sample Size

• Staff input– Throughout development and

completion of the questionnaires, Aralias Research received input from FCCBH staff

• Phone Questionnaire– Performed 90 surveys assessing client

satisfaction •35 Adult surveys•30 Child surveys (Parent Proxy)•25 Youth surveys

Potential Errors and BiasesPotential Errors and Biases• Sampling Error- does the sample represent the

entire population?– Sample was generated using a random number

generator

• Response Error- did the respondents understand and answer all the questions in the questionnaire?• We controlled the understanding and response

rates for each question• Distractions such as TV, family, other

engagements, and mood may skew results

• Non-Response Error- were there non-respondents?– Several phones were disconnected– No Answers (not home or not answering)

Summary of ResponsesSummary of Responses• Adult

– 35 Adults were surveyed•Ages 18 +

– 46 Questions were asked

• Youth & Children– 55 Youth and Parent Surveys

•Ages 0 – 12 (Child with Proxy Parents)

•Ages 13 – 17 (Youth)

Youth/Parent Survey Youth/Parent Survey Satisfaction Satisfaction

Category ComparisonsCategory Comparisons1.1. Location and Time of ServicesLocation and Time of Services2.2. Knowledge of Access to Emergency CareKnowledge of Access to Emergency Care3.3. Scope of ServiceScope of Service4.4. Timeliness of ServicesTimeliness of Services5.5. Access to TransportationAccess to Transportation6.6. Access to Complaint ProcessAccess to Complaint Process7.7. Staff Interaction and Service QualityStaff Interaction and Service Quality8.8. Quality of Medical Management ServicesQuality of Medical Management Services9.9. Cultural SensitivityCultural Sensitivity10.10. TreatmentTreatment11.11. Improved Interpersonal RelationsImproved Interpersonal Relations12.12. Overall SatisfactionOverall Satisfaction

Location and Time of Location and Time of ServicesServices

Location and Time of Services (2002 vs. 2003)

50.80%

18.18%11.10%

61.82%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002 SurveySurvey Study Groups

Per

cent

age

Satis

fact

ion

StronglyAgreeAgree

Question #18: The location of services was convenient.Question #19: Services were available during hours that were convenient.

Knowledge of AccessKnowledge of Accessto Emergency Careto Emergency Care

Knowledge of Access to Emergency Care (2002 vs. 2003)

58.18%38.30%

16.36%

10%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002 Survey

Survey Study Groups

Perc

enta

ge S

atis

fact

ion

StronglyAgreeAgree

Question #24: My caregivers adequately explained how to get emergency mental health services if I wanted them.

Scope of ServicesScope of Services

Scope of Service [Questions #8 and #17] (2002 vs. 2003)

66.36%36.10%

21.82%

6.60%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002Survey

Survey Study Groups

Per

cent

age

Satis

fact

ion

StronglyAgreeAgree

Scope of Service [Question #23] (2002 vs. 2003)

38.18%21.90%

16.36%

10.90%

0%10%20%

30%40%50%60%70%

80%90%

100%

BYU 2003 Survey Maximus 2002 SurveySurvey Study Groups

StronglyAgreeAgree

Question #23: “I got the help I needed.”

Question #8: “I feel that my opinion was valued in choosing the services I received.”

Question #17: “I received services that were right for me.”

Timeliness of ServiceTimeliness of Service

Timeliness of Service (2002 vs. 2003)

54.55%32.30%

20.00%

8.10%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002 Survey

Survey Study Groups

Per

cent

age

Satis

fact

ion

StronglyAgreeAgree

Question #11: “I felt I had someone to talk to when I was troubled.”Question #20: “I was able to get appointments with my caregivers as soon as I wanted.”

Access to TransportationAccess to TransportationAccess to Transportation (2002 vs. 2003)

40.00%26.20%

16.36%

7.10%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002 Survey

Survey Study Groups

Per

cent

age

Satisf

action

StronglyAgreeAgree

Question #32: “My caregivers helped me with transportation to and from mental health services when I needed it.”

Access to Complaint Access to Complaint ProcessProcess

Access to Complaint Process [question #25] (2002 vs. 2003)

54.55% 50.80%

23.64%14.30%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002 SurveySurvey Study Groups

Perc

entag

e Sa

tisfac

tion Strongly

AgreeAgree

Access to Complaint Process [question #26] (2002 vs. 2003)

29.09% 26.80%

21.82%3.60%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002 SurveySurvey Study Groups

Perc

entag

e Sa

tisfac

tion

StronglyAgreeAgree

Question #25: “I felt free to complain when I was unhappy with the services provided.”

Question #26: “My caregivers or office staff adequately explained to me how to file a complaint if I had one.”

Staff Interaction and Staff Interaction and Service QualityService Quality

Staff Interaction and Service Quality [questions #27 and #28] (2002 vs. 2003)

55.45% 46%

38.18%

19%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002Survey

Survey Study Groups

Perc

enta

ge S

atis

faca

tion

StronglyAgreeAgree

Staff Interaction and Service Quality [questions #12, #15, and #29] (2002 vs. 2003)

56.97%41.70%

27.88%

13.30%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002SurveySurvey Study Groups

Per

cent

age

Satisf

action

StronglyAgreeAgree

Question #12: “I felt comfortable asking questions about my treatment.”Question #15: “The people helping me listened to what I had to say.”Question #29: “My caregivers spoke with me in a way that I understood.”

Question #27: “My caregivers treated me with courtesy and respect.”Question #28: “Office staff treated me with courtesy and respect.”

Staff Interaction and Staff Interaction and Service Quality (cont.)Service Quality (cont.)

Question #10: “I felt that my caregivers stuck with me no matter what.”

Staff Interaction and Service Quality [question #10] (2002 vs. 2003)

52.73%34.90%

32.73%

17.50%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002 Survey

Survey Study Groups

Per

cent

age

Satis

fact

ion

StronglyAgreeAgree

Quality of Medical Quality of Medical Management ServicesManagement Services

Quality of Medical Management Services (2002 vs. 2003)

40.00% 42.60%

25.45% 19.10%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002 Survey

Survey Study Groups

Perc

enta

ge

Satis

faca

tion

StronglyAgreeAgree

Question #13: “I felt comfortable asking questions about my medication.”

Cultural SensitivityCultural Sensitivity

Cultural Sensitivity (2002 vs. 2003)

66.36%48.00%

25.45%

12.00%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002 Survey

Survey Study Groups

Perc

enta

ge

Satis

fact

ion

StronglyAgreeAgree

Question #30: “My caregivers were sensitive to my cultural/ethnic background.”Question #31: “Office staff were sensitive to my cultural/ethnic background.”

TreatmentTreatment

Treatment (2002 vs. 2003)

60.00%42.60%

24.55%

9.80%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002 Survey

Survey Study Groups

Perc

enta

ge

Satis

fact

ion

StronglyAgreeAgree

Question #9: “I feel my input was valued in choosing my treatment goals.”Question #16: “I was actively involved in my own treatment.”

Improved Interpersonal Improved Interpersonal RelationsRelations

Improved Interpersonal Relations [question #4] (2002 vs. 2003)

54.55% 44.40%

14.55%6.30%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey Maximus 2002Survey

Survey Study Groups

Per

centa

ge

Satisf

action

StronglyAgreeAgree

Question #4: “I get along better with friends and other people.”

Question #3: “I get along better with family members.”Question #7: “I am satisfied with my family life right now.”

Improved Interpersonal Relations [questions #3 and #7] (2003)

53.64%

13.64%

0%

20%

40%

60%

80%

100%

BYU 2003 Survey

Survey Study Groups

Perc

enta

ge S

atisfa

ctio

n

StronglyAgreeAgree

Overall SatisfactionOverall Satisfaction

Overall Satisfaction [question #21] (2002 vs. 2003)

58.18%31.30%

29.09%

18.80%

0%20%40%60%80%

100%

BYU 2003 Survey Maximus 2002Survey

Survey Study Groups

Pe

rce

nta

ge

S

ati

sfa

cti

on

StronglyAgreeAgree

Overall Satisfaction [question #22] (2002 vs. 2003)

50.91%31.30%

20.00%14.10%

0%20%40%60%80%

100%

BYU 2003Survey

Maximus 2002Survey

Survey Study Groups

Per

cen

tag

e S

atis

fact

ion

StronglyAgreeAgree

Question #21: “If I need services in the future, I would use these services again.”

Question #22: “I got the help I wanted.”

Adult Survey Satisfaction Adult Survey Satisfaction Category ComparisonsCategory Comparisons

1.1. Timeliness of ServiceTimeliness of Service

2.2. Scope of ServiceScope of Service

3.3. Cultural SensitivityCultural Sensitivity

4.4. Access to TransportationAccess to Transportation

5.5. Service QualityService Quality

Timeliness of Service Timeliness of Service (Adult)(Adult)

Timeliness of Service (2002 vs. 2003)

57.14%43.00%

31.43%

34.10%

0%

20%

40%

60%

80%

100%

BYU Fall 2003 Maximus 2002

Survey Study Groups

Perc

en

tag

e S

ati

sfa

cti

on

Strongly Agree

Agree

Question #5: My caregivers were willing to help as often as I felt necessary.

Scope of Service (Adult)Scope of Service (Adult)Scope of Service (2002 vs. 2003)

28.57%8.90%

17.14%

5.20%0%

20%

40%

60%

80%

100%

BYU Fall 2003 Maximus 2002

Survey Study Groups

Per

cen

tag

e S

atis

fact

ion

StronglyAgreeAgree

Question #8: I was able to get all the services I thought I needed.

Cultural Sensitivity Cultural Sensitivity (Adult)(Adult)

Cultural Sensitivity (2002 vs. 2003)

42.86% 40.40%

22.86% 30.10%

0%

20%

40%

60%

80%

100%

BYU Fall 2003 Maximus 2002

Survey Study Goups

Pe

rce

nta

ge

Sa

tis

fac

tio

n

StronglyAgreeAgree

Question # 24: My caregivers were sensitive to my cultural/ethnic background.

Question # 25: The office staff was sensitive to my cultural/ethnic background.

Access to Transportation Access to Transportation (Adult)(Adult)

Access to Transportation (2002 vs. 2003)

20.00%33.60%

18.57%

19.20%

0%

20%

40%

60%

80%

100%

BYU Fall 2003 Maximus 2002

Survey Study Groups

Perc

en

tag

e S

ati

sfa

cti

on

StronglyAgreeAgree

Question #29: My caregivers helped me to mental health services when I needed it.

Service Quality (Adult)Service Quality (Adult)Service Quality (2002 vs 2003)

20.00%7.40%

12.86%

2.90%0%

20%

40%

60%

80%

100%

BYU Fall 2003 Maximus 2002

Survey Study Groups

Per

cen

tag

e o

f R

esp

on

ses

StronglyAgreeAgree

Question #28: My caregivers were competent and knowledgeable.

If you could see one thing If you could see one thing improved…what would it improved…what would it

be?be? More counselors and appointment openingsMore counselors and appointment openings

• ““My child needs frequent visits for better My child needs frequent visits for better attention.”attention.”

• ““FCCBH needs more counselors to free up more FCCBH needs more counselors to free up more time for my child’s to have time with his counselor.”time for my child’s to have time with his counselor.”

• ““More available therapists for one-on-one More available therapists for one-on-one counseling.”counseling.”

Closer 24-hour crisis centerCloser 24-hour crisis center After school appointmentsAfter school appointments

• ““Don’t make my child miss school.”Don’t make my child miss school.”• ““More variety of services to accommodate youth and More variety of services to accommodate youth and

children.”children.”

What was the single most What was the single most helpful service received at helpful service received at

FCCBH?FCCBH? ““[My son’s] mental health has improved a [My son’s] mental health has improved a

great deal.” (2 to a 6 on question #35)great deal.” (2 to a 6 on question #35) ““Lorna Jensen. She is good and does her Lorna Jensen. She is good and does her

best to help.”best to help.” ““My child has had someone to talk to.”My child has had someone to talk to.” ““The therapy my child received helped The therapy my child received helped

realize he isn’t a bad kid and gave him realize he isn’t a bad kid and gave him alternative solutions to his past behavior.”alternative solutions to his past behavior.”

““Everyone helps everyone. It helps to know Everyone helps everyone. It helps to know they are there.”they are there.”

Chi-Square Tests for Chi-Square Tests for Statistical SignificanceStatistical Significance

The following chi-square tests show response The following chi-square tests show response category comparisons where statistical category comparisons where statistical significance (minimum 90% confidence level) significance (minimum 90% confidence level) was found in the association between the two was found in the association between the two response categories:response categories:

1.1. Frequency of Visits vs. Overall SatisfactionFrequency of Visits vs. Overall Satisfaction

2.2. Scope vs. Overall SatisfactionScope vs. Overall Satisfaction

3.3. Timeliness vs. Overall SatisfactionTimeliness vs. Overall Satisfaction

4.4. Treatment vs. Overall SatisfactionTreatment vs. Overall Satisfaction

Frequency of Visits Frequency of Visits vs. Overall Satisfactionvs. Overall Satisfaction

Chi-Square Tests

112.225a 30 .000

35.177 30 .236

89

Pearson Chi-Square

Likelihood Ratio

N of Valid Cases

Value dfAsymp. Sig.

(2-sided)

34 cells (81.0%) have expected count less than 5. Theminimum expected count is .01.

a.

For 30 df the Pearson Chi-Square value is 40.2560 .

Scope vs. Overall Scope vs. Overall SatisfactionSatisfaction

Chi-Square Tests

36.316a 20 .014

32.024 20 .043

18.547 1 .000

89

Pearson Chi-Square

Likelihood Ratio

Linear-by-LinearAssociation

N of Valid Cases

Value dfAsymp. Sig.

(2-sided)

24 cells (80.0%) have expected count less than 5. Theminimum expected count is .03.

a.

For 20 df the Pearson Chi-Square value is 28.4120.

Scope vs. Overall Scope vs. Overall SatisfactionSatisfaction

Chi-Square Tests

67.694a 12 .000

46.972 12 .000

18.641 1 .000

89

Pearson Chi-Square

Likelihood Ratio

Linear-by-LinearAssociation

N of Valid Cases

Value dfAsymp. Sig.

(2-sided)

14 cells (70.0%) have expected count less than 5. Theminimum expected count is .10.

a.

For 12 df the Pearson Chi-Square value is 18.5494 .

Treatment vs. Overall Treatment vs. Overall SatisfactionSatisfaction

Chi-Square Tests

77.110a 20 .000

37.154 20 .011

21.076 1 .000

89

Pearson Chi-Square

Likelihood Ratio

Linear-by-LinearAssociation

N of Valid Cases

Value dfAsymp. Sig.

(2-sided)

24 cells (80.0%) have expected count less than 5. Theminimum expected count is .02.

a.

For 20 df the Pearson Chi-Square value is 28.4120 .

Treatment vs. Overall Treatment vs. Overall SatisfactionSatisfaction

Chi-Square Tests

55.448a 12 .000

42.069 12 .000

22.308 1 .000

89

Pearson Chi-Square

Likelihood Ratio

Linear-by-LinearAssociation

N of Valid Cases

Value dfAsymp. Sig.

(2-sided)

14 cells (70.0%) have expected count less than 5. Theminimum expected count is .07.

a.

For 12 df the Pearson Chi-Square value is

18.5494 .

How is FCCBH doing now?How is FCCBH doing now?(Youth/Parent comparisons)(Youth/Parent comparisons)

CATEGORYCATEGORYCOMPARISONSCOMPARISONS

Maximus Maximus 20022002

TOTALSTOTALS

BYU 2003BYU 2003SurveySurvey

TOTALSTOTALS

Increase Increase oror

Decrease?Decrease?1.Location and Time of Services 1.Location and Time of Services 61.90% 80.00% 18.10%

2.Knowledge of Access to 2.Knowledge of Access to Emergency Care Emergency Care 48.30% 74.54% 27.15%

3.Scope of Service 3.Scope of Service 42.7% and

32.8%88.18% and

54.55% 33.62%

4.Timeliness of Services 4.Timeliness of Services 40.40% 74.55% 34.15%

5.Access to Transportation 5.Access to Transportation 33.30% 56.36% 23.06%

6.Access to Complaint Process 6.Access to Complaint Process 77% and 21.456.36% and

78.18% 18.07%

7.Staff Interaction and Service 7.Staff Interaction and Service Quality Quality

40.87% and 16.6%

55.05% and 32.93% 15.25%

8.Quality of Medical 8.Quality of Medical Management Services Management Services

42.6% and 19.1%

40% and 25.45% 1.88%

9.Cultural Sensitivity 9.Cultural Sensitivity 48% and 12%66.36% and

25.45% 15.91%

10.Treatment 10.Treatment 42.6% and 9.8%60% and

24.55% 16.08%

11.Improved Interpersonal 11.Improved Interpersonal Relations Relations Not Available

54.09% and 14.09% Not Available

12.Overall Satisfaction 12.Overall Satisfaction 31.3% and

16.45%24.54% and

54.54 15.67%

How is FCCBH doing How is FCCBH doing now?now?(Adult comparisons)(Adult comparisons)

CATEGORYCATEGORYCOMPARISONSCOMPARISONS

Maximus Maximus 20022002

TOTALSTOTALS

BYU BYU 20032003

SurveySurveyTOTALSTOTALS

Increase Increase oror

Decrease?Decrease?

Timeliness of Services 77.10% 88.57% 11.47%

Scope of Services 24.80% 45.71% 20.91%

Cultural Sensitivity 70.50% 65.71% (4.79%)

Access to Transportation 52.80% 38.57% (14.23%)

Service Quality 10.30% 32.86% 22.56%

Summarized Results…Summarized Results…

Total BYU 2003 Survey Summary

(excluding questions #1 and #33-#36)

2.22%8.07% 11.02%

50.18%

27.13%

1.39%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Strongly

Disagree

Disagree Neutral Agree Strongly Agree N/ A

Response Options

Percent

Satisf action

(90 respondents)

ConclusionsConclusions

Areas of Concern:Areas of Concern:– Access to Transportation for adults (14.23% Access to Transportation for adults (14.23%

decrease)decrease)– Quality of Medical Management Services for Quality of Medical Management Services for

youth and children (only a 1.88% increase)youth and children (only a 1.88% increase)

Greatest Accomplishments:Greatest Accomplishments:– Service Quality among adults (22.56% increase)Service Quality among adults (22.56% increase)– Scope of Services for all clients (20.91% Scope of Services for all clients (20.91%

increase for adults and 33.63% increase increase for adults and 33.63% increase youth/children)youth/children)

– Timeliness of Services (11.47% increase for Timeliness of Services (11.47% increase for adults and 34.15% increase for youth/children)adults and 34.15% increase for youth/children)