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Exit Criteria #4
DEMONSTRATED PLANNING FOR AND DELIVERY OF EFFECTIVE AND SUFFICIENT CONSUMER SERVICES
COMMUNITY SERVICE REVIEWS OF CHILDREN AND YOUTH
REQUIREMENTS OF THE EXIT CRITERIA ORDER
Exit Criterion # 4 requires that DMH conduct annual consumer reviews of children and youth, using a stratified random sample of individuals who have received services within the DMH system with a sample size sufficient to provide statistical levels of confidence. The annual reviews—conducted by an independent review team—collect data through a combination of consumer and family interviews, record review, staff interviews, caregiver interviews and document reviews.
The Exit Criteria Order requires that the annual consumer review of children and youth cover seven (7) domains:
• community living
• life skills
• health and development
• treatment
• family support
• systems capacity for prevention and early intervention
• service system capacity.
The Court Required Performance Level is an aggregate score of 80% for positive system performance for the children and youth who are sampled and reviewed.
IMPLEMENTATION ACTIVITIES
To begin the process of meeting the requirements of the Exit Criteria Order, the Dixon Court Monitor retained Human Systems and Outcomes, Inc. (HSO) to assist in developing the child review protocol. HSO is an organization with extensive experience in qualitative child service review processes used in monitoring services in class action litigation in numerous states across the country. Representatives from the provider community and DMH worked with HSO to develop the child review protocol.
The Child Review Protocol* was developed, tested, revised, and then used to create a baseline for subsequent measurement of progress. The child review protocol is scored using a Roll-Up Sheet* that evaluates the following three main areas:
• child and family status (overall child status)
• recent progress
• current practice performance (overall system performance)
Since the initial review, the design of the sampling process, training of reviewers, supervision of data collection, and analysis of data for the child/youth community service reviews have been conducted by HSO, under contract with the Dixon Court Monitor. HSO was contracted by the Dixon Court Monitor and worked as staff to the monitor in conducting the reviews. Logistical preparation and organization of the on-site case review activities was completed by Consumer Action Network (CAN).
2003 Review
The initial review was completed in March 2003 with a sample of 35 children and youth. Reviews were conducted by a team of external reviewers contracted by HSO and DMH staff trained on the protocol. Logistical support was provided by CAN. HSO issued a 2003 Report* on the results of the review which was discussed in the Court Monitor’s July 2003 report.
The results for the 2003 review had 77% of the children and youth with overall child status ratings in the acceptable range. Overall system performance was acceptable for 46% of the children and youth in the 2003 review.
2004 Review
The 2004 review had a larger sample of 54 children and youth. Review activities were completed in March 2004. Reviews were conducted by a team of external reviewers contracted by HSO and DMH staff trained on the protocol. Logistical support was provided by CAN. HSO issued a 2004 Report* on the results of the review, which was discussed in the Court Monitor’s July 2004 report.
The results for the 2004 review had 74% of the children and youth with overall acceptable child status ratings. Overall system performance was acceptable for 43% of the children and youth in the 2004 review.
2005 Review
The 2005 review had a smaller sample of 43 children and youth. Review activities were completed in April 2005. Reviews were conducted by a team of external reviewers contracted by HSO and DMH staff trained on the protocol. Logistical support was provided by CAN. HSO issued a 2005 Report* on the results of the 2005 review which was discussed in the Court Monitor’s July 2005 report.
The results for the 2005 review had 72% of the children and youth with overall acceptable child status ratings. Overall system performance was acceptable for 47% of the children and youth in the 2005 review.
2006 Review
The 2006 review had a sample of 54 children and youth. Review activities were completed in April 2006. Reviews were conducted by a team of external reviewers contracted by HSO and DMH staff trained on the protocol. Logistical support was provided by CAN. HSO issued a 2006 Report on the results of the 2006 review which was discussed in the Court Monitor’s July 2006 report.
The results for the 2006 review had 81% of the children and youth with overall acceptable child status ratings. Overall system performance was acceptable for 54% of the children and youth in the 2006 review.
2007 Review
The 2007 review had a sample of 52 children and youth. Review activities were conducted in March 2007. Reviews were conducted by a team of external reviewers contracted by HSO and DMH staff trained on the protocol. Logistical support was provided by CAN. HSO issued a 2007 Report* on the results of the 2007 review which was discussed in the Court Monitor’s July 2007 report.
The results of the 2007 review had 75% of the children and youth with overall acceptable child status ratings. Overall system performance was found acceptable for 48% of the children and youth in the 2007 review.
2008 Review
In a letter dated August 24, 2007*, DMH proposed changes to the review process that were agreed upon by the Dixon Court Monitor in a letter dated October 25, 2007* to further refine the case review and scoring process.
The 2008 review had a sample of 73 children and youth. Review activities were conducted in March 2008. Reviews were conducted by a team of external reviewers contracted by HSO and DMH staff trained on the protocol. Logistical support was provided by CAN. HSO issued a 2008 Report* on the results of the 2008 review which will be discussed in the Court Monitor’s July 2008 report.
The results of the 2008 review had 79% of the children and youth with overall acceptable child status ratings. Overall system performance was found acceptable for 36% of the children and youth in the 2008 review.
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