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Presentation to DASA Director 20120210
1. Welcome to
Aunt Martha’s Youth Service Center
Theodora Binion, Director
Division of Alcohol and Substance Abuse
Illinois Department of Human Services
February 10, 2012
2. Organizational Overview
Our Mission By the Numbers
Aunt Martha’s mission is to Founded: 1972
be a caring community Locations: 49
resource for children, youth Communities Served: 645
and families. Budget (Total): $70,612,400
Employees (Total): 1,099
Salaried 935
Volunteer 94
Ind. Contractor 70
3. Organizational Structure Board of
Directors
Chief Executive
President
Officer
C. Gary Leofanti
Raul Garza
OPERATIONS ADMINISTRATION
HEALTHWORKS &
COMMUNITY-BASED CHILD WELFARE EDUCATION & EVENING HEALTH CARE Chief Financial
SERVICES SERVICES YOUTH SERVICES REPORTING SERVICES Officer
CENTERS
Chris Nordloh
Senior Vice President Senior Vice President Vice President Vice President Medical Director Chief Compliance
Community-Based Child Welfare Services Education & Youth HealthWorks & Evening Dr. Jennifer Byrd Officer
Services Programming Reporting Centers
Karen Sneade Mary Martin
Jerry Lowell Jill Eitel Dr. Theresa Miller
Director Director
Health & Dental Health Business Chief Quality
Children's Business Operations Operations Officer
Behavioral Health
Reception Jamie Dornfeld Gary Bevills Ernie Gonzalez
Services Division
Center
Division Manager
Vice President
Division Manager Health Care Director
Community-Based Residential
Services Social Services Policy & Advocacy
Services
Warren Wood Roshanda Jackson Marsha Conroy
Giselle Doyle
Community-Based Teen Parenting
Services
Services Network
Division Manager
Foster Care
Marc Smith
4. Our Employees
Gender
20%
Average Tenure of
80% Current Employees:
4.21 Years
Female Male
Race/Ethnicity Advancing
Employee Education
6% Associate’s Degree: 4%
26% 50% Bachelor’s Degree: 32%
18% Master’s Degree: 12%
MD or Ph.D.: 12%
African-American
Hispanic or Latino
White
Other
6. • Drop-In Center
• Counseling Services
• 1st Foster Homes
• Family Planning Services
• 1st Group Home
• Employment Training
7. The 1980s
‘83
• Program Plus (Parents
Learning Universal Skills)
‘85
• Named Head Start Site
‘86
• Comprehensive
Community-Based Youth
Services
‘87
• Project New Chance
8. The 1990s
‘90 ‘96
• 4 New Group Homes • School-Linked Health
‘92 Centers in Aurora and
• Youth Substance Abuse Chicago Heights
Treatment Services
‘94 ‘97
• 3 New Group Homes • Joint Commission
‘95 Accreditation
• 2 New Group Homes ‘99
• Lakehouse Diagnostic • Federally Qualified Health
Shelter Center Status
• Transitional Living Program
9. The 2000s
‘00 ‘06
• Joint Commission Accreditation • Joint Commission Accreditation
‘02 • Health Center
• 2 New Health Centers • Residential Shelter (CRC)
‘03 • Group Home
• Joint Commission Accreditation ‘07
• Health Center • 2 New Health Centers
• Transitional Living Program • Transitional Living Program
‘04 ‘08
• 2 New Health Centers • 4 New Health Centers
‘05 ‘09
• Health Center • 2 New Health Centers
• HealthWorks • ARRA Funding (IDS & CIP)
• Transitional Living Program
10. • ARRA Funding (FIP)
• Chicago Southland
Health Conference
• Partnering for Solutions
Child Welfare Conference
• Health Center
• Park Forest Hall of Fame
• 2nd Annual Partnering for
Solutions Child Welfare
Conference
11.
12. Adult Education Parents Too Soon
(Healthy Families Illinois)
Cook County Works
Pregnant and
Early Learning Center
Parenting Teens
Home Instruction for Parents
Safety Networks
of Preschool Youngsters
Summer Youth Employment
iLab – Community Technology
Center Teen Parenting
Service Network
Life Skills
Teen Pregnancy Prevention
Parenting Classes
Work First
Parenting Techniques
Education Series Youth Participation
13. Basic Center Residential Shelter
Emergency Shelter Care Specialized Foster Care
Foster Home Licensing Street Outreach Program
Homeless Services System of Care
Housing Advocacy Traditional Foster Care
On Your Own Transitional Living Program
Pathways Independent Living Youth Housing Advocacy
Residential Group
Home Services
14. Community
Counseling Services
(Title XX)
Comprehensive Community
Based Youth Services
Comprehensive Prevention
Differential Response
Evening Reporting Center
Gays and Lesbians
Advocating Diversity
Intact Families
Pre-Trial Services
15. Adolescent & Adult Men’s Clinic
Substance Abuse
Mobile Health Center
Treatment
Oral Health
Behavioral Health
Pediatrics
Centering Pregnancy
Primary Care
Comprehensive Prevention
Recreation & Wellness
Family Case Management
Targeted Intensive Prenatal
Family Planning
Case Management
HealthWorks
Teen Clinic
HIV Prevention
Teen Parent Services
Illinois Breast & Cervical
Women’s Health Services
Cancer Program
(OB/GYN)
16. Aunt Martha’s Health Center
350,000
300,000
250,000
200,000 DEVELOPING
LEARNING TO BE A EXPANDING ACCESS TO
AN FQHC COMPREHENSIVE COMPREHENSIVE MODEL
150,000 MODEL
Patients
100,000 Visits
50,000
0
CY CY CY CY CY CY CY CY CY CY CY
'00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10
UDS Reporting Year
17. The People We Serve
Aunt Martha's Illinois' CHCs All CHCs
60.00%
50.00%
40.00%
55.45%
52.47%
39.74%
30.00%
37.67%
31.24%
37.54%
20.00% 15.22%
7.51% 10.84%
10.00%
5.46%
1.60% 5.28%
0.00%
Uninsured Medicaid/CHIP Medicare Other 3rd Party
Source: UDS Summary Report – 2010. Grantee, State and National - Universal
18. Primary Care Services
Patient Centered Medical Home
• Patient-centered, Physician-directed
• Care that is effective and efficient
Chronic Care Management Model
Women’s Health Services
Family Planning
Obstetrics/Gynecology
Breast and Cervical Cancer Screenings
22. Cost Efficient, Coordinated Dental Services
60,000
Cost Per Dental Patient
$400
50,000
$350 $358 $372
$333 $344
$300
40,000 Patients
$274
$250 $247 $248 $259
Visits $255
$200 $249
30,000
According to the most recent data $195
$150 $181
available for state and national levels
20,000 $100 $128
(calendar year 2010), Aunt Martha’s
serves 15 percent of all the patients
$50
10,000
receiving dental services from a BPHC
$-
grantee in Illinois. 2007
2006 2008 2009 2010
-
Aunt Martha's CHCs in Illinois CHCs in U.S.
2004 2006 2008 2010
2003 2004 2005 2006 2007 2008 2009 2010
Patients 1,257 2,087 3,239 6,179 13,459 15,413 20,294 25,248
Visits 2,030 2,412 5,379 10,377 22,546 30,902 44,713 55,539
23. The Care Management Model at Work
Health Treatment in
% of Patients Plan % with Treatment
Compliance % of Patients
Center Active Treatment Completed Non-Compliant
Carpentersville 68% 32% -
Chicago Heights 62% 38% -
Hazel Crest 60% 40% -
Iroquois County 92% 8% -
South Holland 54% 46% -
Southeast Side 59% 33% 7%
Vermilion Area 83% 16% 1%
Women’s Health Ctr. 46% 54% -
24. Behavioral Health Care Services
Child & Adolescent
Psychiatry and Therapy
Individual Counseling
Comprehensive Diagnostic
Evaluation & Treatment
Telepsychiatry
Reaching children and families in some of Illinois’
most isolated communities
26. Cost Efficient, Coordinated Mental Health Services
35,000 Cost Per Mental Health Patient
$655 $653
$700 $600 $605
30,000 $569 $572
$600
$529
25,000
$500 $559
$541
$493 $462 $493
20,000
$400
15,000 According to the most recent data
$300
available for state and national levels
Patients
10,000
Visits
(calendar year 2010), Aunt Martha’s
$200
serves 15 percent $100all the patients
of
5,000
receiving behavioral health services
$-
- from a BPHC grantee in Illinois.
2006 2007 2008 2009 2010
2004 2006 2008 2010 Aunt Martha's CHCs in Illinois CHCs in U.S.
2003 2004 2005 2006 2007 2008 2009 2010
Patients 210 945 878 2,632 3,916 4,757 6,265 7,647
Visits 625 2,793 3,515 11,731 21,819 26,120 31,474 35,704
27. The Care Management Model at Work
Pt. Not Hospitalized during 90.21%
treatment
Pt. reports symptom improvement 92.27%
within 3 months
Compliant with Meds 90.72%
85.30%
# appts attended
96.39%
Consent Signed
81.96%
Medical/Physical in File
70% 75% 80% 85% 90% 95% 100%
28. The Care Management Model at Work
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Under 18 Under 21 adult
29.
30. Cross-Integration and the
Evolution of Aunt Martha’s
• This notion is not new.
• Our services were born out of client needs
– Youth needed someone to talk to (counselors)
– Drug use (substance abuse services)
– Kicked out (foster homes)
– Pregnant (prenatal and family planning)
– Jobs (employment)
– Kids (childcare)
31. Core Training for All Employees
• 4 hour training
• Help you better serve clients and patients by teaching
you what cross-integration is, and why and how we do it
• Lecture, discussion, group activities, video, software
demonstrations, Q&A
• 6 Modules
– Understanding Cross-Integration
– Knowledge of current programs, services, locations and eligibility
– Using the Client Referral System
– Using the Cross-Integration application
– The “VIP” protocol
– Accountability and Making it Real
32. Making Connections and Coordinating Care
Our Cross-Integration System enables employees to search a
centralized database of each client's service history at Aunt Martha's.
33. Aunt Martha’s Cross-Integration System
Once a record is selected, staff can:
1. Review Client History;
2. See the Client's Location on an interactive map; or,
3. View Suggested Programs for the client.
34. Aunt Martha’s Cross-Integration System
The list of Suggested Programs can be changed by
adjusting a filter of selected client characteristics.
35. Aunt Martha’s Cross-Integration System
When a Suggested Program is selected, the interactive map is updated to
show:
1. The client's home address; and,
2. The Locations where the selected program provides its services.
36. Aunt Martha’s Cross-Integration System
From within the Cross-Integration
System, employees can generate an
electronic referral to any of Aunt Martha's
programs.
The status of each record created in our
Referral Tracking System can be
monitored by our managers to ensure
that it is acted on and closed in a timely
manner.
37. Aunt Martha’s Cross-Integration System
From within the Cross-Integration
System, employees can generate an
From July 2010 through June 2011 any of Aunt Martha's
electronic referral to
(FY11), a total of 3,821 requests were
programs.
logged in the Referral Tracking System.
The status of each record created in our
Referral Tracking System can be
monitored by our managers to ensure
More than 3,100 requests have already closed in a timely
that it is acted on and
been logged in FY12.
manner.
38. Cross-Integration,
Coordinated Care & Collaboration
• Services organized from the
client’s perspective
• Integration of child
welfare, juvenile justice and
education services with the
Medical Home
• Alignment with local
networks of health care and
social service providers in
every community
• Implementation of systems
to enable communication and
simplify access and the
coordination of care
39. Client Experiences – Case Study
A 17 year old young man accessed services through our
street outreach program and was referred to our homeless
shelter when we discovered he did not have a permanent
residence. At the shelter he received help with
interpersonal skills, like skills, academic enrollment and job
preparations skills.
Using our integrated network he also received services at
our health center, participated in youth leadership
opportunities and discharged to job corp with his HS
Diploma where he is learning carpentry skills.
40. Client Experiences – Case Study
An 18-year old female from Haiti was brought to Aunt
Martha’s by the police after it was discovered that she was
homeless. She participated in our life skills programs, re-
enrolled in school and began working toward reunifying her
family.
When she left Aunt Martha’s, she moved into the home of a
family member and began aftercare. The family struggled.
Eventually, the young woman was referred to our
Greenhouse Shelter to ensure she continued to her work in
school, job preparation and family communication.
41. Bringing the Value to Life
Telling the Stories of our Patients & Clients
If Ernie sends the five or six bullets Karen asked him for about the
value added initiatives, we can use them here.
42. Incorporating SBIRT Into
Aunt Martha’s Model of Care
• Previous Experience with Similar Tools
– Depression Screening Tool
– Dental Health Questionnaire
• Automated Patient Check-In
– Phreesia demonstration
• Our Adult Patients in South Suburban Cook
County
GARZAThe story of Aunt Martha’s actually begins in 1969, when Park Forest formed a Youth Commission to advise the Village Board about the challenges that the area’s young people were encountering. The Youth Commission was also responsible for recommending strategies to address the needs and challenges it uncovered.In 1972 the Village allocated funds to hire a full-time Youth Worker to:Conduct a more thorough analysis of the needs that had been identified by the Youth Commission; and,Provide guidance and lead the development of programs and initiatives.By the end of 1972, the majority of the Youth Worker’s time was being spent training the volunteers – including youth and adults – who would staff the new walk-in counseling center for runaways and alienated youth. The drop-in center was called Aunt Martha’s, and it opened in December of 1972. The Youth Worker, Gary Leofanti would act as its executive director (in addition to his duties as a Village employee).
Primary Care ServicesHealthWorks, Family Medicine, Internal Medicine, School-Based Health Care, Immunizations, Laboratory Services, Medication Management & Assistance, HIV/AIDS Services, Walk-in ServicesMay want to highlight specialty clinics like Teen Clinic and Men’s Clinic.Women’s Health ServicesFamily Planning, Obstetrics/Gynecology, Pre- and Postnatal Care, Immunizations, Pregnancy Tests, Pap Smears, Breast Cancer Screenings, Cervical Cancer ScreeningsOur Women’s Health Services are integrated with programs that provide education, access to other resources in the community and serve as a social support system for many of our patients. (i.e. Healthy Start, Family Case Management, Targeted Intensive Prenatal Case Management and Teen Parent Services)In Calendar Year 2010:Obstetricians & Gynecologists provided almost 29,000 visits;Case Managers and Patient Educators provided more than 13,000 visits.# of Prenatal Care Patients who Delivered in 2010: 1,232
Aunt Martha’s Total Cost Per Total Patient is 12% lower than the average for Illinois’ health centers, and 23% lower than the national average.WHAT DOES THIS MEAN?WE SEE MORE PATIENTS AND WE DO IT MORE COST EFFECTIVELY THAN THE COMPETITION.
KEY POINTS:Care Management ModelPersonal Dental QuestionnaireCalendar Year 2010 Stats:25,248 Patients55,539 Visits, including: - 26,320 oral exams - 11,693 restorative procedures - 5,994 extractions and other surgical proceduresFACTS ABOUT KIDS ORAL HEALTH CAREDental care is the single greatest unmet need for health services among children.Every year, 17 million disadvantaged children do not receive the dental care they need.Tooth decay is the most common childhood disease. It affects nearly 60 percent of children.80 percent of dental disease is concentrated in just 25 percent of children – those who come from poor families that face disproportionately high barriers to getting care.
Nearly 30% of our health center patients received dental services in CY 2010.State Average: 14.81%National Average: 19.26%Aunt Martha’s Dental Cost Per Dental Patient is 10% lower than the average for Illinois’ health centers, and 34% lower than the national average.WHAT DOES THIS MEAN?WE SEE MORE PATIENTS AND WE DO IT MORE COST EFFECTIVELY THAN THE COMPETITION.
Nearly 30% of our health center patients received dental services in CY 2010.State Average: 14.81%National Average: 19.26%Aunt Martha’s Dental Cost Per Dental Patient is 10% lower than the average for Illinois’ health centers, and 34% lower than the national average.WHAT DOES THIS MEAN?WE SEE MORE PATIENTS AND WE DO IT MORE COST EFFECTIVELY THAN THE COMPETITION.
Calendar Year 2010 Stats:7,647 Patients, including: - 5,527 (72%) diagnosed with depression or other mood disorders - 1,547 (20%) diagnosed with anxiety disorders - 3,019 (39%) diagnosed with attention deficit and disruptive behavior disorders 35,704 VisitsFACTS ABOUT KIDS BEHAVIORAL HEALTH CAREChildren’s Behavioral Health Problems are WidespreadAlmost one in five (1/5) young people have one or more mental, emotional and behavioral disorder.One in 10 youth has mental health problems that are severe enough to impair how they function at home, school or in the community. Early Detection and Intervention Are CriticalResearch supported by the National Institute of Mental Health indicates that half of adults with mental, emotional and behavioral disorders were first diagnosed by age 14 and three-fourths were diagnosed by age 24.Factors that predict mental health problems can be identified in the early years, with children and youth from low-income households at increased risk for mental health problems. Need for Improved and Expanded Mental Health Services for Children & Youth is Well-DocumentedIt is estimated that less than one in five (1/5) children receive the appropriate needed treatment.
9% of our health center patients received mental health services in CY 2010.State Average: 4.30%National Average: 4.38%Aunt Martha’s Mental Health Cost Per Mental Health Patient is 27% lower than the national average.WHAT DOES THIS MEAN?WE SEE MORE PATIENTS AND WE DO IT MORE COST EFFECTIVELY THAN THE COMPETITION.Our psychiatric staff represents 22% of the total psychiatric FTEs in all of Illinois’ community health centers.LIMITATIONS- Ideal continuum for FQHC BH is less seriously mentally ill patients- Who already access the FQHC for medical careEven though We already see well over 100 with a diagnosis of schizophrenia FINANCIAL LIMITATIONS- 330 Funding provides limited funding for uninsured FQHCs cannot be the primary provider of BH services to the Seriously Mentally IllBI-DIRECTIONAL INTEGRATIONGreat potential, but…- Needs to be funded- FQHCs need Change of Scope to provide primary care in CMHC Practice has to recognize that regular productivity is less SUMMARY- FQHCs can be a model for the integration of primary and behavioral healthcare - Successful implementation requires effective systems and management- BH should be integrated into all areas of clinic functioningFQHC-CMHC collaboration is promising but should not be viewed as an alternative to CMHCs for Seriously Mentally Ill
9% of our health center patients received mental health services in CY 2010.State Average: 4.30%National Average: 4.38%Aunt Martha’s Mental Health Cost Per Mental Health Patient is 27% lower than the national average.WHAT DOES THIS MEAN?WE SEE MORE PATIENTS AND WE DO IT MORE COST EFFECTIVELY THAN THE COMPETITION.Our psychiatric staff represents 22% of the total psychiatric FTEs in all of Illinois’ community health centers.LIMITATIONS- Ideal continuum for FQHC BH is less seriously mentally ill patients- Who already access the FQHC for medical careEven though We already see well over 100 with a diagnosis of schizophrenia FINANCIAL LIMITATIONS- 330 Funding provides limited funding for uninsured FQHCs cannot be the primary provider of BH services to the Seriously Mentally IllBI-DIRECTIONAL INTEGRATIONGreat potential, but…- Needs to be funded- FQHCs need Change of Scope to provide primary care in CMHC Practice has to recognize that regular productivity is less SUMMARY- FQHCs can be a model for the integration of primary and behavioral healthcare - Successful implementation requires effective systems and management- BH should be integrated into all areas of clinic functioningFQHC-CMHC collaboration is promising but should not be viewed as an alternative to CMHCs for Seriously Mentally Ill
GARZA
Services organized from the client’s perspective.Founded as a result of the Park Forest Youth Commission.FQHC designation requires that Board includes patient representation.Care Management Model – personalized assistance to help patients navigate the system.Full integration across continuum of child welfare, juvenile justice, education and health care services.HealthWorks and CRC as examples of how healthcare services have been combined with child welfare services.In Fiscal Year 2011, employees logged more than 1,000 referrals to other programs or services in the Aunt Martha’s system.Aligned with other health care and social service providers in every community.Partnerships with 291 health care, dental and behavioral health-related providers and organizations.Partnerships with 535 education and social service-related providers and organizations.Partnerships with 688 religious institutions and organizations.Partnerships with 385 government, civil service and other institutions and organizations.Integrated IT system to enable communication and simplify access to services.Cross-Integration System, which unifies the records of clients whose service information is maintained in multiple, program-specific systems.Client Referral System.‘Request Appointment’ function on the agency’s website, which is linked to and has logged more than 2,800 requests in the Client Referral System since December 2010.
THIS SLIDE IS ABOUT HOW WE ARE EXTENDING OUR RESOURCES BEYOND THE PEOPLE WE SERVE DIRECTLY AND MAKING THEM AVAILABLE TO OTHER ORGANIZATIONS IN THE COMMUNITY.