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2014
Mental Health Targeted Case Management Providers Accessibility Survey
The following information is provided by participating South Country Health Alliance MH-TCM providers who filled out the 2014 Department of Human Services Accessibility Survey. All network MH-TCM providers were invited to take the survey, however not all invited providers responded. This list shows information from those who responded. “Not Answered” means a provider did not provide a response to the survey question.
Agency: Northern Pines Mental Health Center Pg 1
Agency Name: Northern Pines Mental Health CenterAgency Address: 1906 ‐ 5th Avenue SE Little Falls, MN 56345 Agency NPI/UMPI #: 1013904051 Agency Contact: Julie Leikvoll, Director of Operations Phone: 218‐821‐7818 Email: jleikvoll@npmh.org
CLIENT ACCESSIBILITY
At the time of scheduling a new client appointment, does your MH‐TCM agency ask if the client has special needs or requires special accommodations?
Yes
Are clients allowed to bring service animals to their appointments? Yes
Do the MH‐TCM case managers in your agency meet with clients in their home?
Yes
Do the MH‐TCM case managers in your agency meet with clients in a community setting of their choice, such as a coffee shop?
Yes
Does your MH‐TCM provider agency offer services by videoconferencing to improve access to services?
Yes
Do you see clients in your MH‐TCM agency office? Yes
Do your waiting areas accommodate wheelchairs? Yes
Can your MH‐TCM agency accommodate a client who needs a private waiting area?
Yes
Do you have a 5‐foot wheelchair turning radius in at least one bathroom stall?
Yes
Can door handles in the client accessible areas be operated with a closed fist?
Yes
Is your reception desk at chair level? Yes
Is your MH‐TCM provider agency able to offer free, on‐site child care so that an adult client can participate in receiving services?
Yes
How soon are clients seen at your office within their scheduled appointment time?
0 ‐ 15 minutes
Agency: Northern Pines Mental Health Center Pg 2
If public transportation is available to your MH‐TCM agency, what is the distance from the agency to public transportation?
At clinic
SCHEDULING
If a client requests an appointment, how long does it usually take to be seen by a MH‐TCM case manager?
Same day
Are clients given written appointment slips for future planned contacts (not just verbal)?
Yes
Do clients have the option to receive appointment reminders by text message for future planned contacts?
Yes
Do clients have the option to receive appointment reminders by phone message for future planned contacts?
Yes
Do your MH‐TCM case managers adjust the length of visits or contact to meet client needs? (Example: two 30 minutes sessions vs. one 60 minute session)
Yes
Are your agency’s MH‐TCMs available evenings to meet with clients if requested?
Yes
Are your agency’s MH‐TCMs available on weekends to meet with clients if requested?
Yes
If a client often misses appointments, how does your MH‐TCM provider agency respond most frequently? If you answer Other, please specify.
Appointment reminder call Postcard reminder Client activation planning
COMMUNICATION
Does your MH‐TCM provider agency allow clients to communicate with their case managers using phone, email or text; and are these communications documented in client file?
Yes
Are client phone calls and emails to your MH‐TCM provider agency returned within 48 hours?
Yes
Agency: Northern Pines Mental Health Center Pg 3
Are client phone calls and emails to your MH‐TCM provider agency documented in client files at the time of response?
Yes
Does your MH‐TCM provider agency review materials for reading level, ease of understanding, non‐use of acronyms and font size before they are given to clients?
Yes
Does your MH‐TCM provider agency hold or participate in advisory committee/s to review policy and procedures for people with physical health or other disabilities?
Yes
If yes, please name the committees, host agency, and how often they meet:
Todd County Local Advisory Council ‐ monthly meeting hosted at Northern Pines;
How often does your staff receive training on dignity, respect and recovery for clients over the age of 21 with disabilities:
Yearly
How often does your staff receive training on dignity, respect and resiliency for clients under the age of 21 with disabilities:
Yearly
TRAINING
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with high anxiety:
Clients choose session sites, staff are trained in anxiety reduction and coping skills thus they can teach, sensitive to transportation needs, allow service animals
Agency: Northern Pines Mental Health Center Pg 4
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with cognitive conditions:
Paraphrase, written information, attentive to level of reading ability, pace the rate of information being presented, collaborate with other team members
What training have your MH‐TCM case managers been given in the past two years (as of survey date) in order to assess the cultural values and beliefs of the clients and how often?
Relias training on cultural sensitivity provided annually. Last year our site hosted a partial day workshop on cultural sensitivity.
What training is your MH‐TCM provider agency staff given on community resources for clients and how often does this training occur?
Our staff works closely with the crisis line. The crisis line updates the resource manual several times a year.
PERSON‐CENTERED PLANNING
Does your MH‐TCM provider agency identify and involve the client’s personal support members in the client’s assessment and planning of their support plan?
Yes
Does your MH‐TCM provider agency involve the client’s identified personal support members in the client’s implementation and reevaluation of their support plan?
Yes
For clients 21 and older, are Individual Community Support Plans (ICSP) signed by the client and (if involved) other supportive individuals?
Yes
For clients 21 and older, are signed copies of the ICSP given to the client?
Yes
Agency: Northern Pines Mental Health Center Pg 5
For clients under 21, are Individual Family Community Support Plans signed by the client and other supportive individuals?
Yes
For clients under 21, are signed copies of Individual Family Community Support Plans given to the client or other supportive individuals?
Yes
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for adults in the preceding month before this survey?
15
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for children in the preceding month before this survey?
15
CULTURAL CONSIDERATIONS
Do your MH‐TCM case managers use a systematic approach to assessing the cultural values and beliefs of the client and incorporate them into their support plan?
Yes
Does your MH‐TCM agency employ case managers that speak languages of client cultural groups?
Yes
Please list what language(s) besides English in which at least one case manager is fluent as of the day you are completing this survey:
Spanish
Does your MH‐TCM agency specialize in working with a specific population?
No
Please describe the specific population(s). Not Answered
Does your MH‐TCM agency provide written materials in languages other than English?
Yes
Please list the other language(s) that your print materials are available under.
Spanish
QUALITY ASSURANCE
Does your MH‐TCM provider agency utilize an annual client satisfaction survey?
Yes
Agency: Northern Pines Mental Health Center Pg 6
Are the results of client satisfaction surveys available to the public? Yes
Where are the results of your client satisfaction survey located? Clinical Director's e‐files
Agency: Sibley County Public Health & Human Services Pg 1
Agency Name: Sibley County Public Health & Human Services Agency Address: 111 Eighth Street Gaylord, MN 55334 Agency NPI/UMPI #: A000072800 Agency Contact: Vicki Stock, Director Phone: 507‐237‐4000 Email: Vicki@co.sibley.mn.us
CLIENT ACCESSIBILITY
At the time of scheduling a new client appointment, does your MH‐TCM agency ask if the client has special needs or requires special accommodations?
Yes
Are clients allowed to bring service animals to their appointments? Yes
Do the MH‐TCM case managers in your agency meet with clients in their home?
Yes
Do the MH‐TCM case managers in your agency meet with clients in a community setting of their choice, such as a coffee shop?
Yes
Does your MH‐TCM provider agency offer services by videoconferencing to improve access to services?
Yes
Do you see clients in your MH‐TCM agency office? Yes
Do your waiting areas accommodate wheelchairs? Yes
Can your MH‐TCM agency accommodate a client who needs a private waiting area?
No
Do you have a 5‐foot wheelchair turning radius in at least one bathroom stall?
No
Can door handles in the client accessible areas be operated with a closed fist?
No
Is your reception desk at chair level? No
Is your MH‐TCM provider agency able to offer free, on‐site child care so that an adult client can participate in receiving services?
No
How soon are clients seen at your office within their scheduled appointment time?
0 ‐ 15 minutes
Agency: Sibley County Public Health & Human Services Pg 2
If public transportation is available to your MH‐TCM agency, what is the distance from the agency to public transportation?
At clinic
SCHEDULING
If a client requests an appointment, how long does it usually take to be seen by a MH‐TCM case manager?
Within 1 week
Are clients given written appointment slips for future planned contacts (not just verbal)?
Yes
Do clients have the option to receive appointment reminders by text message for future planned contacts?
No
Do clients have the option to receive appointment reminders by phone message for future planned contacts?
No
Do your MH‐TCM case managers adjust the length of visits or contact to meet client needs? (Example: two 30 minutes sessions vs. one 60 minute session)
Yes
Are your agency’s MH‐TCMs available evenings to meet with clients if requested?
Yes
Are your agency’s MH‐TCMs available on weekends to meet with clients if requested?
No
If a client often misses appointments, how does your MH‐TCM provider agency respond most frequently? If you answer Other, please specify.
Appointment reminder call
COMMUNICATION
Does your MH‐TCM provider agency allow clients to communicate with their case managers using phone, email or text; and are these communications documented in client file?
Yes
Are client phone calls and emails to your MH‐TCM provider agency returned within 48 hours?
Yes
Agency: Sibley County Public Health & Human Services Pg 3
Are client phone calls and emails to your MH‐TCM provider agency documented in client files at the time of response?
Yes
Does your MH‐TCM provider agency review materials for reading level, ease of understanding, non‐use of acronyms and font size before they are given to clients?
No
Does your MH‐TCM provider agency hold or participate in advisory committee/s to review policy and procedures for people with physical health or other disabilities?
No
If yes, please name the committees, host agency, and how often they meet:
How often does your staff receive training on dignity, respect and recovery for clients over the age of 21 with disabilities:
Less than or at least every 6 months
How often does your staff receive training on dignity, respect and resiliency for clients under the age of 21 with disabilities:
Less than or at least every 6 months
TRAINING
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with high anxiety:
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with cognitive conditions:
What training have your MH‐TCM case managers been given in the past two years (as of survey date) in order to assess the cultural values and beliefs of the clients and how often?
Internal training ‐ ongoing by Supervisor and annually by Agency Director.
What training is your MH‐TCM provider agency staff given on community resources for clients and how often does this training occur?
Ongoing discussions with Supervisor and other agency personnel.
PERSON‐CENTERED PLANNING
Agency: Sibley County Public Health & Human Services Pg 4
Does your MH‐TCM provider agency identify and involve the client’s personal support members in the client’s assessment and planning of their support plan?
Yes
Does your MH‐TCM provider agency involve the client’s identified personal support members in the client’s implementation and reevaluation of their support plan?
Yes
For clients 21 and older, are Individual Community Support Plans (ICSP) signed by the client and (if involved) other supportive individuals?
Yes
For clients 21 and older, are signed copies of the ICSP given to the client?
Yes
For clients under 21, are Individual Family Community Support Plans signed by the client and other supportive individuals?
Yes
For clients under 21, are signed copies of Individual Family Community Support Plans given to the client or other supportive individuals?
Yes
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for adults in the preceding month before this survey?
28
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for children in the preceding month before this survey?
28
CULTURAL CONSIDERATIONS
Do your MH‐TCM case managers use a systematic approach to assessing the cultural values and beliefs of the client and incorporate them into their support plan?
Yes
Does your MH‐TCM agency employ case managers that speak languages of client cultural groups?
Yes
Please list what language(s) besides English in which at least one case manager is fluent as of the day you are completing this survey:
Spanish
Agency: Sibley County Public Health & Human Services Pg 5
Does your MH‐TCM agency specialize in working with a specific population?
No
Please describe the specific population(s). Not Answered
Does your MH‐TCM agency provide written materials in languages other than English?
Yes
Please list the other language(s) that your print materials are available under.
Spanish
QUALITY ASSURANCE
Does your MH‐TCM provider agency utilize an annual client satisfaction survey?
No
Are the results of client satisfaction surveys available to the public? Not Answered
Where are the results of your client satisfaction survey located? Not Answered
Agency: Kanabec County Pg 1
Agency Name: Kanabec CountyAgency Address: 905 E Forest Mora, MN 55051 Agency NPI/UMPI #: 1700047552 Agency Contact: Charles Hurd, Adult Services Supervisor Phone: 320‐679‐6357 Email: Chuck.hurd@co.kanabec.mn.us
CLIENT ACCESSIBILITY
At the time of scheduling a new client appointment, does your MH‐TCM agency ask if the client has special needs or requires special accommodations?
Yes
Are clients allowed to bring service animals to their appointments? Yes
Do the MH‐TCM case managers in your agency meet with clients in their home?
Yes
Do the MH‐TCM case managers in your agency meet with clients in a community setting of their choice, such as a coffee shop?
Yes
Does your MH‐TCM provider agency offer services by videoconferencing to improve access to services?
Yes
Do you see clients in your MH‐TCM agency office? Yes
Do your waiting areas accommodate wheelchairs? Yes
Can your MH‐TCM agency accommodate a client who needs a private waiting area?
Yes
Do you have a 5‐foot wheelchair turning radius in at least one bathroom stall?
Yes
Can door handles in the client accessible areas be operated with a closed fist?
Yes
Is your reception desk at chair level? Yes
Is your MH‐TCM provider agency able to offer free, on‐site child care so that an adult client can participate in receiving services?
Yes
How soon are clients seen at your office within their scheduled appointment time?
0 ‐ 15 minutes
Agency: Kanabec County Pg 2
If public transportation is available to your MH‐TCM agency, what is the distance from the agency to public transportation?
At clinic
SCHEDULING
If a client requests an appointment, how long does it usually take to be seen by a MH‐TCM case manager?
Within 48 hours
Are clients given written appointment slips for future planned contacts (not just verbal)?
Yes
Do clients have the option to receive appointment reminders by text message for future planned contacts?
Yes
Do clients have the option to receive appointment reminders by phone message for future planned contacts?
Yes
Do your MH‐TCM case managers adjust the length of visits or contact to meet client needs? (Example: two 30 minutes sessions vs. one 60 minute session)
Yes
Are your agency’s MH‐TCMs available evenings to meet with clients if requested?
Yes
Are your agency’s MH‐TCMs available on weekends to meet with clients if requested?
No
If a client often misses appointments, how does your MH‐TCM provider agency respond most frequently? If you answer Other, please specify.
Terminate services Appointment reminder call Postcard reminder
COMMUNICATION
Does your MH‐TCM provider agency allow clients to communicate with their case managers using phone, email or text; and are these communications documented in client file?
Yes
Are client phone calls and emails to your MH‐TCM provider agency returned within 48 hours?
Yes
Agency: Kanabec County Pg 3
Are client phone calls and emails to your MH‐TCM provider agency documented in client files at the time of response?
Yes
Does your MH‐TCM provider agency review materials for reading level, ease of understanding, non‐use of acronyms and font size before they are given to clients?
No
Does your MH‐TCM provider agency hold or participate in advisory committee/s to review policy and procedures for people with physical health or other disabilities?
Yes
If yes, please name the committees, host agency, and how often they meet:
The county has many meetings to discuss safety and access in its departments including SS/PHN.
How often does your staff receive training on dignity, respect and recovery for clients over the age of 21 with disabilities:
Yearly
How often does your staff receive training on dignity, respect and resiliency for clients under the age of 21 with disabilities:
Yearly
TRAINING
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with high anxiety:
We use person‐centered approaches and staffing of specific client issues including anxiety to meet the issues involved in the delivery of our services.
Agency: Kanabec County Pg 4
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with cognitive conditions:
We use person‐centered approaches and staffing of specific client issues including cognative conditions to meet the issues involved in the delivery of our services.
What training have your MH‐TCM case managers been given in the past two years (as of survey date) in order to assess the cultural values and beliefs of the clients and how often?
This varies staff to staff. We currently do not have a minority or ethnic group in our county. If one should move into our area we would develop specific training to work with that group.
What training is your MH‐TCM provider agency staff given on community resources for clients and how often does this training occur?
We have limited staff and providers. We have staff that work closely and attend many team meetings with one and other that gives each one the oppertunity to learn about community resources.
PERSON‐CENTERED PLANNING
Does your MH‐TCM provider agency identify and involve the client’s personal support members in the client’s assessment and planning of their support plan?
Yes
Agency: Kanabec County Pg 5
Does your MH‐TCM provider agency involve the client’s identified personal support members in the client’s implementation and reevaluation of their support plan?
Yes
For clients 21 and older, are Individual Community Support Plans (ICSP) signed by the client and (if involved) other supportive individuals?
Yes
For clients 21 and older, are signed copies of the ICSP given to the client?
Yes
For clients under 21, are Individual Family Community Support Plans signed by the client and other supportive individuals?
Yes
For clients under 21, are signed copies of Individual Family Community Support Plans given to the client or other supportive individuals?
No
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for adults in the preceding month before this survey?
25
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for children in the preceding month before this survey?
12
CULTURAL CONSIDERATIONS
Do your MH‐TCM case managers use a systematic approach to assessing the cultural values and beliefs of the client and incorporate them into their support plan?
Yes
Does your MH‐TCM agency employ case managers that speak languages of client cultural groups?
No
Please list what language(s) besides English in which at least one case manager is fluent as of the day you are completing this survey:
Not Answered
Does your MH‐TCM agency specialize in working with a specific population?
No
Please describe the specific population(s). Not Answered
Agency: Kanabec County Pg 6
Does your MH‐TCM agency provide written materials in languages other than English?
Yes
Please list the other language(s) that your print materials are available under.
We have a service that covers any language if needed
QUALITY ASSURANCE
Does your MH‐TCM provider agency utilize an annual client satisfaction survey?
No
Are the results of client satisfaction surveys available to the public? Not Answered
Where are the results of your client satisfaction survey located? Not Answered
Agency: Quality Case Management, Inc. Pg 1
Agency Name: Quality Case Management, Inc.Agency Address: 203 10th Ave NW Austin, MN 55912 Agency NPI/UMPI #: 1578658282 Agency Contact: Gary T. Corcoran, Owner/President Phone: 507‐437‐9085 Email: gtcorcoran@charter.net
CLIENT ACCESSIBILITY
At the time of scheduling a new client appointment, does your MH‐TCM agency ask if the client has special needs or requires special accommodations?
Yes
Are clients allowed to bring service animals to their appointments? Yes
Do the MH‐TCM case managers in your agency meet with clients in their home?
Yes
Do the MH‐TCM case managers in your agency meet with clients in a community setting of their choice, such as a coffee shop?
Yes
Does your MH‐TCM provider agency offer services by videoconferencing to improve access to services?
No
Do you see clients in your MH‐TCM agency office? Yes
Do your waiting areas accommodate wheelchairs? No
Can your MH‐TCM agency accommodate a client who needs a private waiting area?
Yes
Do you have a 5‐foot wheelchair turning radius in at least one bathroom stall?
Can door handles in the client accessible areas be operated with a closed fist?
Yes
Is your reception desk at chair level? Yes
Is your MH‐TCM provider agency able to offer free, on‐site child care so that an adult client can participate in receiving services?
No
How soon are clients seen at your office within their scheduled appointment time?
0 ‐ 15 minutes
Agency: Quality Case Management, Inc. Pg 2
If public transportation is available to your MH‐TCM agency, what is the distance from the agency to public transportation?
1‐6 blocks
SCHEDULING
If a client requests an appointment, how long does it usually take to be seen by a MH‐TCM case manager?
Within 1 week
Are clients given written appointment slips for future planned contacts (not just verbal)?
Yes
Do clients have the option to receive appointment reminders by text message for future planned contacts?
No
Do clients have the option to receive appointment reminders by phone message for future planned contacts?
Yes
Do your MH‐TCM case managers adjust the length of visits or contact to meet client needs? (Example: two 30 minutes sessions vs. one 60 minute session)
Yes
Are your agency’s MH‐TCMs available evenings to meet with clients if requested?
Yes
Are your agency’s MH‐TCMs available on weekends to meet with clients if requested?
Yes
If a client often misses appointments, how does your MH‐TCM provider agency respond most frequently? If you answer Other, please specify.
Appointment reminder call Client activation planning Other: Every C/M can be reached by their cell phone. Calls are returned within 24 hrs.
COMMUNICATION
Does your MH‐TCM provider agency allow clients to communicate with their case managers using phone, email or text; and are these communications documented in client file?
Yes
Agency: Quality Case Management, Inc. Pg 3
Are client phone calls and emails to your MH‐TCM provider agency returned within 48 hours?
Yes
Are client phone calls and emails to your MH‐TCM provider agency documented in client files at the time of response?
No
Does your MH‐TCM provider agency review materials for reading level, ease of understanding, non‐use of acronyms and font size before they are given to clients?
Yes
Does your MH‐TCM provider agency hold or participate in advisory committee/s to review policy and procedures for people with physical health or other disabilities?
Yes
If yes, please name the committees, host agency, and how often they meet:
CREST Advisory (Qtr) ‐ LAC (mo) ‐ CSSA (mo) ‐ Adult Protection (mo) ‐ CSP (mo) ‐ C/M Forums (mo)
How often does your staff receive training on dignity, respect and recovery for clients over the age of 21 with disabilities:
Yearly
How often does your staff receive training on dignity, respect and resiliency for clients under the age of 21 with disabilities:
Yearly
TRAINING
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with high anxiety:
Relaxation ‐ coping skills ‐ deep breathing exercises
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with cognitive conditions:
Handouts ‐ supportive services
What training have your MH‐TCM case managers been given in the past two years (as of survey date) in order to assess the cultural values and beliefs of the clients and how often?
Instruction at time of hire.
What training is your MH‐TCM provider agency staff given on community resources for clients and how often does this training occur?
CSSA Mtg monthly along with weekly staff meetings.
Agency: Quality Case Management, Inc. Pg 4
PERSON‐CENTERED PLANNING
Does your MH‐TCM provider agency identify and involve the client’s personal support members in the client’s assessment and planning of their support plan?
Yes
Does your MH‐TCM provider agency involve the client’s identified personal support members in the client’s implementation and reevaluation of their support plan?
Yes
For clients 21 and older, are Individual Community Support Plans (ICSP) signed by the client and (if involved) other supportive individuals?
Yes
For clients 21 and older, are signed copies of the ICSP given to the client?
Yes
For clients under 21, are Individual Family Community Support Plans signed by the client and other supportive individuals?
Not applicable, our agency does not service clients under the age of 21.
For clients under 21, are signed copies of Individual Family Community Support Plans given to the client or other supportive individuals?
Not applicable, our agency does not service clients under the age of 21.
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for adults in the preceding month before this survey?
29
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for children in the preceding month before this survey?
Not Answered
CULTURAL CONSIDERATIONS
Do your MH‐TCM case managers use a systematic approach to assessing the cultural values and beliefs of the client and incorporate them into their support plan?
Yes
Agency: Quality Case Management, Inc. Pg 5
Does your MH‐TCM agency employ case managers that speak languages of client cultural groups?
No
Please list what language(s) besides English in which at least one case manager is fluent as of the day you are completing this survey:
Not Answered
Does your MH‐TCM agency specialize in working with a specific population?
Yes
Please describe the specific population(s). Adults with a mental illness
Does your MH‐TCM agency provide written materials in languages other than English?
No
Please list the other language(s) that your print materials are available under.
Not Answered
QUALITY ASSURANCE
Does your MH‐TCM provider agency utilize an annual client satisfaction survey?
Yes
Are the results of client satisfaction surveys available to the public? Yes
Where are the results of your client satisfaction survey located? They are in the office and available upon request.
Agency: Fernbrook Family Center Pg 1
Agency Name: Fernbrook Family CenterAgency Address: 419 Bush St Red Wing, MN 55066 Agency NPI/UMPI #: 143742791 Agency Contact: Jill Tourney, Children's Mental Health Case Manager Supervisor Phone: 651‐212‐7429 Email: jtourney@fernbrook.org
CLIENT ACCESSIBILITY
At the time of scheduling a new client appointment, does your MH‐TCM agency ask if the client has special needs or requires special accommodations?
Yes
Are clients allowed to bring service animals to their appointments? Yes
Do the MH‐TCM case managers in your agency meet with clients in their home?
Yes
Do the MH‐TCM case managers in your agency meet with clients in a community setting of their choice, such as a coffee shop?
Yes
Does your MH‐TCM provider agency offer services by videoconferencing to improve access to services?
No
Do you see clients in your MH‐TCM agency office? Yes
Do your waiting areas accommodate wheelchairs? Yes
Can your MH‐TCM agency accommodate a client who needs a private waiting area?
Yes
Do you have a 5‐foot wheelchair turning radius in at least one bathroom stall?
Yes
Can door handles in the client accessible areas be operated with a closed fist?
No
Is your reception desk at chair level? NA
Is your MH‐TCM provider agency able to offer free, on‐site child care so that an adult client can participate in receiving services?
No
How soon are clients seen at your office within their scheduled appointment time?
0 ‐ 15 minutes
Agency: Fernbrook Family Center Pg 2
If public transportation is available to your MH‐TCM agency, what is the distance from the agency to public transportation?
1‐6 blocks
SCHEDULING
If a client requests an appointment, how long does it usually take to be seen by a MH‐TCM case manager?
Within 1 week
Are clients given written appointment slips for future planned contacts (not just verbal)?
No
Do clients have the option to receive appointment reminders by text message for future planned contacts?
Yes
Do clients have the option to receive appointment reminders by phone message for future planned contacts?
Yes
Do your MH‐TCM case managers adjust the length of visits or contact to meet client needs? (Example: two 30 minutes sessions vs. one 60 minute session)
Yes
Are your agency’s MH‐TCMs available evenings to meet with clients if requested?
Yes
Are your agency’s MH‐TCMs available on weekends to meet with clients if requested?
No
If a client often misses appointments, how does your MH‐TCM provider agency respond most frequently? If you answer Other, please specify.
Appointment reminder call Other:
COMMUNICATION
Does your MH‐TCM provider agency allow clients to communicate with their case managers using phone, email or text; and are these communications documented in client file?
Yes
Are client phone calls and emails to your MH‐TCM provider agency returned within 48 hours?
Yes
Agency: Fernbrook Family Center Pg 3
Are client phone calls and emails to your MH‐TCM provider agency documented in client files at the time of response?
Yes
Does your MH‐TCM provider agency review materials for reading level, ease of understanding, non‐use of acronyms and font size before they are given to clients?
No
Does your MH‐TCM provider agency hold or participate in advisory committee/s to review policy and procedures for people with physical health or other disabilities?
No
If yes, please name the committees, host agency, and how often they meet:
How often does your staff receive training on dignity, respect and recovery for clients over the age of 21 with disabilities:
Less than or at least every 6 months
How often does your staff receive training on dignity, respect and resiliency for clients under the age of 21 with disabilities:
Less than or at least every 6 months
TRAINING
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with high anxiety:
The staff is trained in coping skills (deep breathing, taking a break, distration, redirecting), private rooms and in‐home visits to reduce anxiety.
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with cognitive conditions:
Agency: Fernbrook Family Center Pg 4
What training have your MH‐TCM case managers been given in the past two years (as of survey date) in order to assess the cultural values and beliefs of the clients and how often?
The staff attends weekly continued education meetings. New employees attend a a weekly new hire meeting for 6 months. Cultural values and beliefs are subjects of these meetings.
What training is your MH‐TCM provider agency staff given on community resources for clients and how often does this training occur?
The staff attends Child Protection meeting weekly to gather resources for the clients. Staff attends county wide mental health collaboration meetings 4 times a year.
PERSON‐CENTERED PLANNING
Does your MH‐TCM provider agency identify and involve the client’s personal support members in the client’s assessment and planning of their support plan?
Yes
Does your MH‐TCM provider agency involve the client’s identified personal support members in the client’s implementation and reevaluation of their support plan?
Yes
For clients 21 and older, are Individual Community Support Plans (ICSP) signed by the client and (if involved) other supportive individuals?
Not applicable, our agency does not service clients over the age of 21.
For clients 21 and older, are signed copies of the ICSP given to the client?
Not applicable, our agency does not service clients over the age of 21.
Agency: Fernbrook Family Center Pg 5
For clients under 21, are Individual Family Community Support Plans signed by the client and other supportive individuals?
Yes
For clients under 21, are signed copies of Individual Family Community Support Plans given to the client or other supportive individuals?
Yes
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for adults in the preceding month before this survey?
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for children in the preceding month before this survey?
15
CULTURAL CONSIDERATIONS
Do your MH‐TCM case managers use a systematic approach to assessing the cultural values and beliefs of the client and incorporate them into their support plan?
Yes
Does your MH‐TCM agency employ case managers that speak languages of client cultural groups?
No
Please list what language(s) besides English in which at least one case manager is fluent as of the day you are completing this survey:
Not Answered
Does your MH‐TCM agency specialize in working with a specific population?
No
Please describe the specific population(s). Not Answered
Does your MH‐TCM agency provide written materials in languages other than English?
Yes
Please list the other language(s) that your print materials are available under.
Spanish
QUALITY ASSURANCE
Does your MH‐TCM provider agency utilize an annual client satisfaction survey?
Yes
Agency: Fernbrook Family Center Pg 6
Are the results of client satisfaction surveys available to the public? No
Where are the results of your client satisfaction survey located? Not Answered
Agency: Olmsted County Pg 1
Agency Name: Olmsted CountyAgency Address: 2100 Campus Drive SE Suite 200 Rochester, MN 55904 Agency NPI/UMPI #: 1053567495 Agency Contact: Mary O'Neil, Adult Behavioral Health Program Manager Phone: 507‐328‐6247 Email: oneil.mary@co.olmsted.mn.us
CLIENT ACCESSIBILITY
At the time of scheduling a new client appointment, does your MH‐TCM agency ask if the client has special needs or requires special accommodations?
Yes
Are clients allowed to bring service animals to their appointments? Yes
Do the MH‐TCM case managers in your agency meet with clients in their home?
Yes
Do the MH‐TCM case managers in your agency meet with clients in a community setting of their choice, such as a coffee shop?
Yes
Does your MH‐TCM provider agency offer services by videoconferencing to improve access to services?
Yes
Do you see clients in your MH‐TCM agency office? Yes
Do your waiting areas accommodate wheelchairs? Not Answered
Can your MH‐TCM agency accommodate a client who needs a private waiting area?
Not Answered
Do you have a 5‐foot wheelchair turning radius in at least one bathroom stall?
Not Answered
Can door handles in the client accessible areas be operated with a closed fist?
Not Answered
Is your reception desk at chair level? Not Answered
Is your MH‐TCM provider agency able to offer free, on‐site child care so that an adult client can participate in receiving services?
Not Answered
How soon are clients seen at your office within their scheduled appointment time?
0 ‐ 15 minutes
Agency: Olmsted County Pg 2
If public transportation is available to your MH‐TCM agency, what is the distance from the agency to public transportation?
At clinic
SCHEDULING
If a client requests an appointment, how long does it usually take to be seen by a MH‐TCM case manager?
Within 2 weeks
Are clients given written appointment slips for future planned contacts (not just verbal)?
Yes
Do clients have the option to receive appointment reminders by text message for future planned contacts?
No
Do clients have the option to receive appointment reminders by phone message for future planned contacts?
Yes
Do your MH‐TCM case managers adjust the length of visits or contact to meet client needs? (Example: two 30 minutes sessions vs. one 60 minute session)
Yes
Are your agency’s MH‐TCMs available evenings to meet with clients if requested?
No
Are your agency’s MH‐TCMs available on weekends to meet with clients if requested?
No
If a client often misses appointments, how does your MH‐TCM provider agency respond most frequently? If you answer Other, please specify.
Appointment reminder call Client activation planning Other: Specific meeting to address voluntary status, barriers, needs for TCM
COMMUNICATION
Does your MH‐TCM provider agency allow clients to communicate with their case managers using phone, email or text; and are these communications documented in client file?
No
Agency: Olmsted County Pg 3
Are client phone calls and emails to your MH‐TCM provider agency returned within 48 hours?
Yes
Are client phone calls and emails to your MH‐TCM provider agency documented in client files at the time of response?
Yes
Does your MH‐TCM provider agency review materials for reading level, ease of understanding, non‐use of acronyms and font size before they are given to clients?
Yes
Does your MH‐TCM provider agency hold or participate in advisory committee/s to review policy and procedures for people with physical health or other disabilities?
No
If yes, please name the committees, host agency, and how often they meet:
How often does your staff receive training on dignity, respect and recovery for clients over the age of 21 with disabilities:
Not at all
How often does your staff receive training on dignity, respect and resiliency for clients under the age of 21 with disabilities:
Not at all
TRAINING
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with high anxiety:
Keep client well informed ahead of time; set expectations ahead of time; varied locations/times to meet.
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with cognitive conditions:
Written materials; calendars; few topics at one time.
What training have your MH‐TCM case managers been given in the past two years (as of survey date) in order to assess the cultural values and beliefs of the clients and how often?
Diversity training offered through the county; training is offered every year.
Agency: Olmsted County Pg 4
What training is your MH‐TCM provider agency staff given on community resources for clients and how often does this training occur?
No formal training occurs; ongoing communication among case managers regarding new resources in community.
PERSON‐CENTERED PLANNING
Does your MH‐TCM provider agency identify and involve the client’s personal support members in the client’s assessment and planning of their support plan?
Yes
Does your MH‐TCM provider agency involve the client’s identified personal support members in the client’s implementation and reevaluation of their support plan?
Yes
For clients 21 and older, are Individual Community Support Plans (ICSP) signed by the client and (if involved) other supportive individuals?
Yes
For clients 21 and older, are signed copies of the ICSP given to the client?
Yes
For clients under 21, are Individual Family Community Support Plans signed by the client and other supportive individuals?
No
For clients under 21, are signed copies of Individual Family Community Support Plans given to the client or other supportive individuals?
No
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for adults in the preceding month before this survey?
30
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for children in the preceding month before this survey?
Not Answered
CULTURAL CONSIDERATIONS
Agency: Olmsted County Pg 5
Do your MH‐TCM case managers use a systematic approach to assessing the cultural values and beliefs of the client and incorporate them into their support plan?
No
Does your MH‐TCM agency employ case managers that speak languages of client cultural groups?
No
Please list what language(s) besides English in which at least one case manager is fluent as of the day you are completing this survey:
Not Answered
Does your MH‐TCM agency specialize in working with a specific population?
No
Please describe the specific population(s). Not Answered
Does your MH‐TCM agency provide written materials in languages other than English?
Yes
Please list the other language(s) that your print materials are available under.
Spanish, Somali
QUALITY ASSURANCE
Does your MH‐TCM provider agency utilize an annual client satisfaction survey?
No
Are the results of client satisfaction surveys available to the public? Not Answered
Where are the results of your client satisfaction survey located? Not Answered
Agency: Goodhue County Social Services Pg 1
Agency Name: Goodhue County Social ServicesAgency Address: 426 West Ave. Red Wing, MN 55066 Agency NPI/UMPI #: A000025600 Agency Contact: Abby Villaran, Social Services Supervisor Phone: 651‐385‐6185 Email: abby.villaran@co.goodhue.mn.us
CLIENT ACCESSIBILITY
At the time of scheduling a new client appointment, does your MH‐TCM agency ask if the client has special needs or requires special accommodations?
Yes
Are clients allowed to bring service animals to their appointments? Yes
Do the MH‐TCM case managers in your agency meet with clients in their home?
Yes
Do the MH‐TCM case managers in your agency meet with clients in a community setting of their choice, such as a coffee shop?
Yes
Does your MH‐TCM provider agency offer services by videoconferencing to improve access to services?
No
Do you see clients in your MH‐TCM agency office? Yes
Do your waiting areas accommodate wheelchairs? Yes
Can your MH‐TCM agency accommodate a client who needs a private waiting area?
No
Do you have a 5‐foot wheelchair turning radius in at least one bathroom stall?
No
Can door handles in the client accessible areas be operated with a closed fist?
No
Is your reception desk at chair level? No
Is your MH‐TCM provider agency able to offer free, on‐site child care so that an adult client can participate in receiving services?
No
How soon are clients seen at your office within their scheduled appointment time?
0 ‐ 15 minutes
Agency: Goodhue County Social Services Pg 2
If public transportation is available to your MH‐TCM agency, what is the distance from the agency to public transportation?
1‐6 blocks
SCHEDULING
If a client requests an appointment, how long does it usually take to be seen by a MH‐TCM case manager?
Within 2 weeks
Are clients given written appointment slips for future planned contacts (not just verbal)?
Yes
Do clients have the option to receive appointment reminders by text message for future planned contacts?
No
Do clients have the option to receive appointment reminders by phone message for future planned contacts?
No
Do your MH‐TCM case managers adjust the length of visits or contact to meet client needs? (Example: two 30 minutes sessions vs. one 60 minute session)
Yes
Are your agency’s MH‐TCMs available evenings to meet with clients if requested?
No
Are your agency’s MH‐TCMs available on weekends to meet with clients if requested?
No
If a client often misses appointments, how does your MH‐TCM provider agency respond most frequently? If you answer Other, please specify.
Postcard reminder
COMMUNICATION
Does your MH‐TCM provider agency allow clients to communicate with their case managers using phone, email or text; and are these communications documented in client file?
Yes
Are client phone calls and emails to your MH‐TCM provider agency returned within 48 hours?
Yes
Agency: Goodhue County Social Services Pg 3
Are client phone calls and emails to your MH‐TCM provider agency documented in client files at the time of response?
Yes
Does your MH‐TCM provider agency review materials for reading level, ease of understanding, non‐use of acronyms and font size before they are given to clients?
No
Does your MH‐TCM provider agency hold or participate in advisory committee/s to review policy and procedures for people with physical health or other disabilities?
No
If yes, please name the committees, host agency, and how often they meet:
How often does your staff receive training on dignity, respect and recovery for clients over the age of 21 with disabilities:
Yearly
How often does your staff receive training on dignity, respect and resiliency for clients under the age of 21 with disabilities:
Yearly
TRAINING
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with high anxiety:
Informal calming exercises such as breathing, bringing to back to physical space, asking person what helps them, bringing someone else (with consent) to appointment, etc.
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with cognitive conditions:
Giving information in different learning styles (verbal, written, different levels of difficulty).
Agency: Goodhue County Social Services Pg 4
What training have your MH‐TCM case managers been given in the past two years (as of survey date) in order to assess the cultural values and beliefs of the clients and how often?
Unsure‐this training is not provided on a regular schedule but case managers have training on various cultural issues.
What training is your MH‐TCM provider agency staff given on community resources for clients and how often does this training occur?
Informal procedure and information of resources. We keep updated information on different resources for numerous issues one might need help with‐accessible to all staff and people served
PERSON‐CENTERED PLANNING
Does your MH‐TCM provider agency identify and involve the client’s personal support members in the client’s assessment and planning of their support plan?
Yes
Does your MH‐TCM provider agency involve the client’s identified personal support members in the client’s implementation and reevaluation of their support plan?
Yes
For clients 21 and older, are Individual Community Support Plans (ICSP) signed by the client and (if involved) other supportive individuals?
Yes
For clients 21 and older, are signed copies of the ICSP given to the client?
Yes
For clients under 21, are Individual Family Community Support Plans signed by the client and other supportive individuals?
Yes
For clients under 21, are signed copies of Individual Family Community Support Plans given to the client or other supportive individuals?
Yes
Agency: Goodhue County Social Services Pg 5
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for adults in the preceding month before this survey?
55
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for children in the preceding month before this survey?
Not Answered
CULTURAL CONSIDERATIONS
Do your MH‐TCM case managers use a systematic approach to assessing the cultural values and beliefs of the client and incorporate them into their support plan?
Yes
Does your MH‐TCM agency employ case managers that speak languages of client cultural groups?
No
Please list what language(s) besides English in which at least one case manager is fluent as of the day you are completing this survey:
Not Answered
Does your MH‐TCM agency specialize in working with a specific population?
No
Please describe the specific population(s). Not Answered
Does your MH‐TCM agency provide written materials in languages other than English?
Yes
Please list the other language(s) that your print materials are available under.
Spanish‐can obtain other languages as needed specific to client needs
QUALITY ASSURANCE
Does your MH‐TCM provider agency utilize an annual client satisfaction survey?
No
Are the results of client satisfaction surveys available to the public? Not Answered
Where are the results of your client satisfaction survey located? Not Answered
Agency: Wadena County Human Services Pg 1
Agency Name: Wadena County Human ServicesAgency Address: 124 1st St. SE Wadena, MN 56482 Agency NPI/UMPI #: M578523500 Agency Contact: Lori Miller, Adult Services Supervisior Phone: 218‐632‐2567 Email: lori.miller@co.wadena.mn.us
CLIENT ACCESSIBILITY
At the time of scheduling a new client appointment, does your MH‐TCM agency ask if the client has special needs or requires special accommodations?
Yes
Are clients allowed to bring service animals to their appointments? Yes
Do the MH‐TCM case managers in your agency meet with clients in their home?
Yes
Do the MH‐TCM case managers in your agency meet with clients in a community setting of their choice, such as a coffee shop?
Yes
Does your MH‐TCM provider agency offer services by videoconferencing to improve access to services?
Yes
Do you see clients in your MH‐TCM agency office? Yes
Do your waiting areas accommodate wheelchairs? Yes
Can your MH‐TCM agency accommodate a client who needs a private waiting area?
Yes
Do you have a 5‐foot wheelchair turning radius in at least one bathroom stall?
Yes
Can door handles in the client accessible areas be operated with a closed fist?
Yes
Is your reception desk at chair level? Yes
Is your MH‐TCM provider agency able to offer free, on‐site child care so that an adult client can participate in receiving services?
Yes
How soon are clients seen at your office within their scheduled appointment time?
0 ‐ 15 minutes
Agency: Wadena County Human Services Pg 2
If public transportation is available to your MH‐TCM agency, what is the distance from the agency to public transportation?
At clinic
SCHEDULING
If a client requests an appointment, how long does it usually take to be seen by a MH‐TCM case manager?
Within 1 week
Are clients given written appointment slips for future planned contacts (not just verbal)?
Yes
Do clients have the option to receive appointment reminders by text message for future planned contacts?
No
Do clients have the option to receive appointment reminders by phone message for future planned contacts?
Yes
Do your MH‐TCM case managers adjust the length of visits or contact to meet client needs? (Example: two 30 minutes sessions vs. one 60 minute session)
Yes
Are your agency’s MH‐TCMs available evenings to meet with clients if requested?
No
Are your agency’s MH‐TCMs available on weekends to meet with clients if requested?
No
If a client often misses appointments, how does your MH‐TCM provider agency respond most frequently? If you answer Other, please specify.
Other: The TCM worker will call to reschedule.
COMMUNICATION
Does your MH‐TCM provider agency allow clients to communicate with their case managers using phone, email or text; and are these communications documented in client file?
Yes
Are client phone calls and emails to your MH‐TCM provider agency returned within 48 hours?
Yes
Agency: Wadena County Human Services Pg 3
Are client phone calls and emails to your MH‐TCM provider agency documented in client files at the time of response?
No
Does your MH‐TCM provider agency review materials for reading level, ease of understanding, non‐use of acronyms and font size before they are given to clients?
Yes
Does your MH‐TCM provider agency hold or participate in advisory committee/s to review policy and procedures for people with physical health or other disabilities?
No
If yes, please name the committees, host agency, and how often they meet:
How often does your staff receive training on dignity, respect and recovery for clients over the age of 21 with disabilities:
Yearly
How often does your staff receive training on dignity, respect and resiliency for clients under the age of 21 with disabilities:
Yearly
TRAINING
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with high anxiety:
Staff on trained on mental health diagnoses and how to approach clients.
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with cognitive conditions:
Staff are trained in cognitive conditions and how to approach consumers.
What training have your MH‐TCM case managers been given in the past two years (as of survey date) in order to assess the cultural values and beliefs of the clients and how often?
Staff attend DHS trainings.
What training is your MH‐TCM provider agency staff given on community resources for clients and how often does this training occur?
No training. Agency has a resource manual for reference.
PERSON‐CENTERED PLANNING
Agency: Wadena County Human Services Pg 4
Does your MH‐TCM provider agency identify and involve the client’s personal support members in the client’s assessment and planning of their support plan?
Yes
Does your MH‐TCM provider agency involve the client’s identified personal support members in the client’s implementation and reevaluation of their support plan?
Yes
For clients 21 and older, are Individual Community Support Plans (ICSP) signed by the client and (if involved) other supportive individuals?
Yes
For clients 21 and older, are signed copies of the ICSP given to the client?
Yes
For clients under 21, are Individual Family Community Support Plans signed by the client and other supportive individuals?
Yes
For clients under 21, are signed copies of Individual Family Community Support Plans given to the client or other supportive individuals?
Yes
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for adults in the preceding month before this survey?
30
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for children in the preceding month before this survey?
24
CULTURAL CONSIDERATIONS
Do your MH‐TCM case managers use a systematic approach to assessing the cultural values and beliefs of the client and incorporate them into their support plan?
No
Does your MH‐TCM agency employ case managers that speak languages of client cultural groups?
No
Please list what language(s) besides English in which at least one case manager is fluent as of the day you are completing this survey:
Not Answered
Agency: Wadena County Human Services Pg 5
Does your MH‐TCM agency specialize in working with a specific population?
No
Please describe the specific population(s). Not Answered
Does your MH‐TCM agency provide written materials in languages other than English?
No
Please list the other language(s) that your print materials are available under.
Not Answered
QUALITY ASSURANCE
Does your MH‐TCM provider agency utilize an annual client satisfaction survey?
No
Are the results of client satisfaction surveys available to the public? Not Answered
Where are the results of your client satisfaction survey located? Not Answered
Agency: South Central Human Relations Center Pg 1
Agency Name: South Central Human Relations CenterAgency Address: 610 Florence Avenue Owatonna, MN 55060 Agency NPI/UMPI #: 1063437564 Agency Contact: Scott Westbrock, MSW, LICSW; Adult Case Management Supervisor Phone: 507‐451‐2630 Email: scottw@schrc.com
CLIENT ACCESSIBILITY
At the time of scheduling a new client appointment, does your MH‐TCM agency ask if the client has special needs or requires special accommodations?
No
Are clients allowed to bring service animals to their appointments? Yes
Do the MH‐TCM case managers in your agency meet with clients in their home?
Yes
Do the MH‐TCM case managers in your agency meet with clients in a community setting of their choice, such as a coffee shop?
Yes
Does your MH‐TCM provider agency offer services by videoconferencing to improve access to services?
No
Do you see clients in your MH‐TCM agency office? Yes
Do your waiting areas accommodate wheelchairs? Yes
Can your MH‐TCM agency accommodate a client who needs a private waiting area?
Yes
Do you have a 5‐foot wheelchair turning radius in at least one bathroom stall?
Yes
Can door handles in the client accessible areas be operated with a closed fist?
Yes
Is your reception desk at chair level? No
Is your MH‐TCM provider agency able to offer free, on‐site child care so that an adult client can participate in receiving services?
No
How soon are clients seen at your office within their scheduled appointment time?
0 ‐ 15 minutes
Agency: South Central Human Relations Center Pg 2
If public transportation is available to your MH‐TCM agency, what is the distance from the agency to public transportation?
1‐6 blocks
SCHEDULING
If a client requests an appointment, how long does it usually take to be seen by a MH‐TCM case manager?
Within 1 week
Are clients given written appointment slips for future planned contacts (not just verbal)?
Yes
Do clients have the option to receive appointment reminders by text message for future planned contacts?
No
Do clients have the option to receive appointment reminders by phone message for future planned contacts?
No
Do your MH‐TCM case managers adjust the length of visits or contact to meet client needs? (Example: two 30 minutes sessions vs. one 60 minute session)
Yes
Are your agency’s MH‐TCMs available evenings to meet with clients if requested?
Yes
Are your agency’s MH‐TCMs available on weekends to meet with clients if requested?
No
If a client often misses appointments, how does your MH‐TCM provider agency respond most frequently? If you answer Other, please specify.
Appointment reminder call Postcard reminder Client activation planning
COMMUNICATION
Does your MH‐TCM provider agency allow clients to communicate with their case managers using phone, email or text; and are these communications documented in client file?
Yes
Are client phone calls and emails to your MH‐TCM provider agency returned within 48 hours?
Yes
Agency: South Central Human Relations Center Pg 3
Are client phone calls and emails to your MH‐TCM provider agency documented in client files at the time of response?
Yes
Does your MH‐TCM provider agency review materials for reading level, ease of understanding, non‐use of acronyms and font size before they are given to clients?
Yes
Does your MH‐TCM provider agency hold or participate in advisory committee/s to review policy and procedures for people with physical health or other disabilities?
Yes
If yes, please name the committees, host agency, and how often they meet:
Minnesota Association of Community Mental Health Programs ‐‐ various meetings for administration
How often does your staff receive training on dignity, respect and recovery for clients over the age of 21 with disabilities:
Yearly
How often does your staff receive training on dignity, respect and resiliency for clients under the age of 21 with disabilities:
Yearly
TRAINING
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with high anxiety:
Meeting with client where comfortable, sitting with client, provide support, quiet , meeting area.
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with cognitive conditions:
Meet at home or comfortable setting, quiet meeting areas.
Agency: South Central Human Relations Center Pg 4
What training have your MH‐TCM case managers been given in the past two years (as of survey date) in order to assess the cultural values and beliefs of the clients and how often?
UCare Cultural Sensitivity Training (also done at time of hire). This is reviewed/assessed with clients every six months. Case managers receive additional training as necessary.
What training is your MH‐TCM provider agency staff given on community resources for clients and how often does this training occur?
On‐the‐job training for learning resources as well as sharing of new resources during staff meetings.
PERSON‐CENTERED PLANNING
Does your MH‐TCM provider agency identify and involve the client’s personal support members in the client’s assessment and planning of their support plan?
Yes
Does your MH‐TCM provider agency involve the client’s identified personal support members in the client’s implementation and reevaluation of their support plan?
Yes
For clients 21 and older, are Individual Community Support Plans (ICSP) signed by the client and (if involved) other supportive individuals?
Yes
For clients 21 and older, are signed copies of the ICSP given to the client?
Yes
For clients under 21, are Individual Family Community Support Plans signed by the client and other supportive individuals?
Yes
For clients under 21, are signed copies of Individual Family Community Support Plans given to the client or other supportive individuals?
Yes
Agency: South Central Human Relations Center Pg 5
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for adults in the preceding month before this survey?
32
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for children in the preceding month before this survey?
22
CULTURAL CONSIDERATIONS
Do your MH‐TCM case managers use a systematic approach to assessing the cultural values and beliefs of the client and incorporate them into their support plan?
Yes
Does your MH‐TCM agency employ case managers that speak languages of client cultural groups?
No
Please list what language(s) besides English in which at least one case manager is fluent as of the day you are completing this survey:
Not Answered
Does your MH‐TCM agency specialize in working with a specific population?
No
Please describe the specific population(s). Not Answered
Does your MH‐TCM agency provide written materials in languages other than English?
No
Please list the other language(s) that your print materials are available under.
Not Answered
QUALITY ASSURANCE
Does your MH‐TCM provider agency utilize an annual client satisfaction survey?
Yes
Are the results of client satisfaction surveys available to the public? No
Where are the results of your client satisfaction survey located? Not Answered
Agency: Zumbro Valley Health Center Pg 1
Agency Name: Zumbro Valley Health CenterAgency Address: 343 Woodlake Drive SE Rochester, MN 55904 Agency NPI/UMPI #: 1801961263 Agency Contact: Tina Nunemacher‐Tews Phone: 507‐535‐5705 Email: tinan@zumbromhc.org
CLIENT ACCESSIBILITY
At the time of scheduling a new client appointment, does your MH‐TCM agency ask if the client has special needs or requires special accommodations?
Yes
Are clients allowed to bring service animals to their appointments? Yes
Do the MH‐TCM case managers in your agency meet with clients in their home?
Yes
Do the MH‐TCM case managers in your agency meet with clients in a community setting of their choice, such as a coffee shop?
Yes
Does your MH‐TCM provider agency offer services by videoconferencing to improve access to services?
No
Do you see clients in your MH‐TCM agency office? Yes
Do your waiting areas accommodate wheelchairs? Yes
Can your MH‐TCM agency accommodate a client who needs a private waiting area?
Yes
Do you have a 5‐foot wheelchair turning radius in at least one bathroom stall?
Yes
Can door handles in the client accessible areas be operated with a closed fist?
Yes
Is your reception desk at chair level? No
Is your MH‐TCM provider agency able to offer free, on‐site child care so that an adult client can participate in receiving services?
No
How soon are clients seen at your office within their scheduled appointment time?
0 ‐ 15 minutes
Agency: Zumbro Valley Health Center Pg 2
If public transportation is available to your MH‐TCM agency, what is the distance from the agency to public transportation?
At clinic
SCHEDULING
If a client requests an appointment, how long does it usually take to be seen by a MH‐TCM case manager?
Same day
Are clients given written appointment slips for future planned contacts (not just verbal)?
No
Do clients have the option to receive appointment reminders by text message for future planned contacts?
Yes
Do clients have the option to receive appointment reminders by phone message for future planned contacts?
Yes
Do your MH‐TCM case managers adjust the length of visits or contact to meet client needs? (Example: two 30 minutes sessions vs. one 60 minute session)
Yes
Are your agency’s MH‐TCMs available evenings to meet with clients if requested?
Yes
Are your agency’s MH‐TCMs available on weekends to meet with clients if requested?
Yes
If a client often misses appointments, how does your MH‐TCM provider agency respond most frequently? If you answer Other, please specify.
Appointment reminder call Postcard reminder Client activation planning
COMMUNICATION
Does your MH‐TCM provider agency allow clients to communicate with their case managers using phone, email or text; and are these communications documented in client file?
No
Are client phone calls and emails to your MH‐TCM provider agency returned within 48 hours?
Yes
Agency: Zumbro Valley Health Center Pg 3
Are client phone calls and emails to your MH‐TCM provider agency documented in client files at the time of response?
Yes
Does your MH‐TCM provider agency review materials for reading level, ease of understanding, non‐use of acronyms and font size before they are given to clients?
Yes
Does your MH‐TCM provider agency hold or participate in advisory committee/s to review policy and procedures for people with physical health or other disabilities?
No
If yes, please name the committees, host agency, and how often they meet:
How often does your staff receive training on dignity, respect and recovery for clients over the age of 21 with disabilities:
Yearly
How often does your staff receive training on dignity, respect and resiliency for clients under the age of 21 with disabilities:
Yearly
TRAINING
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with high anxiety:
Design meeting locations, duration, frequency of appointments to meet the client needs.
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with cognitive conditions:
Change approaches to meet clients needs.
What training have your MH‐TCM case managers been given in the past two years (as of survey date) in order to assess the cultural values and beliefs of the clients and how often?
Cultural considerations and a panel discussion.
What training is your MH‐TCM provider agency staff given on community resources for clients and how often does this training occur?
Monthly staff meetings and individual clinical supervision.
PERSON‐CENTERED PLANNING
Agency: Zumbro Valley Health Center Pg 4
Does your MH‐TCM provider agency identify and involve the client’s personal support members in the client’s assessment and planning of their support plan?
Yes
Does your MH‐TCM provider agency involve the client’s identified personal support members in the client’s implementation and reevaluation of their support plan?
Yes
For clients 21 and older, are Individual Community Support Plans (ICSP) signed by the client and (if involved) other supportive individuals?
Yes
For clients 21 and older, are signed copies of the ICSP given to the client?
Yes
For clients under 21, are Individual Family Community Support Plans signed by the client and other supportive individuals?
Yes
For clients under 21, are signed copies of Individual Family Community Support Plans given to the client or other supportive individuals?
Yes
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for adults in the preceding month before this survey?
28
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for children in the preceding month before this survey?
14
CULTURAL CONSIDERATIONS
Do your MH‐TCM case managers use a systematic approach to assessing the cultural values and beliefs of the client and incorporate them into their support plan?
Yes
Does your MH‐TCM agency employ case managers that speak languages of client cultural groups?
Yes
Please list what language(s) besides English in which at least one case manager is fluent as of the day you are completing this survey:
Vietnamese, Cambodian, Somali
Agency: Zumbro Valley Health Center Pg 5
Does your MH‐TCM agency specialize in working with a specific population?
Yes
Please describe the specific population(s). Somali, Vietnamese, Cambodian, ethnicity
Does your MH‐TCM agency provide written materials in languages other than English?
Yes
Please list the other language(s) that your print materials are available under.
Somali, Cambodian, Vietnamese
QUALITY ASSURANCE
Does your MH‐TCM provider agency utilize an annual client satisfaction survey?
Yes
Are the results of client satisfaction surveys available to the public? No
Where are the results of your client satisfaction survey located? Not Answered
Agency: Brown County Family Services Pg 1
Agency Name: Brown County Family ServicesAgency Address: 1117 Center Street New Ulm, MN 56073 Agency NPI/UMPI #: A000008600 Agency Contact: Barb Dietz, Adult Social Service Supervisor Phone: 507‐359‐6538 Email: barb.dietz@co.brown.mn.us
CLIENT ACCESSIBILITY
At the time of scheduling a new client appointment, does your MH‐TCM agency ask if the client has special needs or requires special accommodations?
Yes
Are clients allowed to bring service animals to their appointments? Yes
Do the MH‐TCM case managers in your agency meet with clients in their home?
Yes
Do the MH‐TCM case managers in your agency meet with clients in a community setting of their choice, such as a coffee shop?
Yes
Does your MH‐TCM provider agency offer services by videoconferencing to improve access to services?
Yes
Do you see clients in your MH‐TCM agency office? Yes
Do your waiting areas accommodate wheelchairs? Yes
Can your MH‐TCM agency accommodate a client who needs a private waiting area?
Yes
Do you have a 5‐foot wheelchair turning radius in at least one bathroom stall?
Yes
Can door handles in the client accessible areas be operated with a closed fist?
No
Is your reception desk at chair level? No
Is your MH‐TCM provider agency able to offer free, on‐site child care so that an adult client can participate in receiving services?
No
How soon are clients seen at your office within their scheduled appointment time?
0 ‐ 15 minutes
Agency: Brown County Family Services Pg 2
If public transportation is available to your MH‐TCM agency, what is the distance from the agency to public transportation?
At clinic
SCHEDULING
If a client requests an appointment, how long does it usually take to be seen by a MH‐TCM case manager?
Within 1 week
Are clients given written appointment slips for future planned contacts (not just verbal)?
Yes
Do clients have the option to receive appointment reminders by text message for future planned contacts?
No
Do clients have the option to receive appointment reminders by phone message for future planned contacts?
No
Do your MH‐TCM case managers adjust the length of visits or contact to meet client needs? (Example: two 30 minutes sessions vs. one 60 minute session)
Yes
Are your agency’s MH‐TCMs available evenings to meet with clients if requested?
Yes
Are your agency’s MH‐TCMs available on weekends to meet with clients if requested?
Yes
If a client often misses appointments, how does your MH‐TCM provider agency respond most frequently? If you answer Other, please specify.
Other: The TCM case mgr will contact client by phone (or letter if no response) to check in
COMMUNICATION
Does your MH‐TCM provider agency allow clients to communicate with their case managers using phone, email or text; and are these communications documented in client file?
Yes
Are client phone calls and emails to your MH‐TCM provider agency returned within 48 hours?
Yes
Agency: Brown County Family Services Pg 3
Are client phone calls and emails to your MH‐TCM provider agency documented in client files at the time of response?
No
Does your MH‐TCM provider agency review materials for reading level, ease of understanding, non‐use of acronyms and font size before they are given to clients?
No
Does your MH‐TCM provider agency hold or participate in advisory committee/s to review policy and procedures for people with physical health or other disabilities?
No
If yes, please name the committees, host agency, and how often they meet:
How often does your staff receive training on dignity, respect and recovery for clients over the age of 21 with disabilities:
Yearly
How often does your staff receive training on dignity, respect and resiliency for clients under the age of 21 with disabilities:
Yearly
TRAINING
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with high anxiety:
MH‐TCM case mgrs trained to deal w/such clients and accomodations made on individual basis.
What accommodations are your MH‐TCM provider agency staff trained in to use regarding individuals with cognitive conditions:
MH‐TCM case mgrs trained to deal w/such clients and accomodations made on individual basis
Agency: Brown County Family Services Pg 4
What training have your MH‐TCM case managers been given in the past two years (as of survey date) in order to assess the cultural values and beliefs of the clients and how often?
Staff attend an annual MH conference and several trainings throughout the year and have the ability to attend sessions to help them assess this.
What training is your MH‐TCM provider agency staff given on community resources for clients and how often does this training occur?
Information on new resources are provided weekly to case managers. Periodically (1‐2x month) presenters come in to talk about the services they offer.
PERSON‐CENTERED PLANNING
Does your MH‐TCM provider agency identify and involve the client’s personal support members in the client’s assessment and planning of their support plan?
Yes
Does your MH‐TCM provider agency involve the client’s identified personal support members in the client’s implementation and reevaluation of their support plan?
Yes
For clients 21 and older, are Individual Community Support Plans (ICSP) signed by the client and (if involved) other supportive individuals?
Yes
For clients 21 and older, are signed copies of the ICSP given to the client?
Yes
For clients under 21, are Individual Family Community Support Plans signed by the client and other supportive individuals?
Yes
For clients under 21, are signed copies of Individual Family Community Support Plans given to the client or other supportive individuals?
Yes
Agency: Brown County Family Services Pg 5
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for adults in the preceding month before this survey?
38
What is the average size of case manager caseload for a full‐time equivalency case manager (do not include supervisor or clinical supervisor time) at your MH‐TCM provider agency for children in the preceding month before this survey?
15
CULTURAL CONSIDERATIONS
Do your MH‐TCM case managers use a systematic approach to assessing the cultural values and beliefs of the client and incorporate them into their support plan?
No
Does your MH‐TCM agency employ case managers that speak languages of client cultural groups?
No
Please list what language(s) besides English in which at least one case manager is fluent as of the day you are completing this survey:
Not Answered
Does your MH‐TCM agency specialize in working with a specific population?
No
Please describe the specific population(s). Not Answered
Does your MH‐TCM agency provide written materials in languages other than English?
No
Please list the other language(s) that your print materials are available under.
Not Answered
QUALITY ASSURANCE
Does your MH‐TCM provider agency utilize an annual client satisfaction survey?
No
Are the results of client satisfaction surveys available to the public? Not Answered
Where are the results of your client satisfaction survey located? Not Answered
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