Health Services Interim Committee October 24 th , 2017 Life Skills and Transition Center Presentation Sue Foerster, M Ed LSTC Superintendent Sue Foerster, M Ed LSTC Superintendent
LSTC VISION Support People to be viable members of their community by providing specialized services when their needs exceed community resources • The LSTC is a service provider amongst the continuum of services for people with intellectual disabilities and serves as the Safety Net. • The LSTC serves people who typically need the highest level of care and have unique and complex medical or behavioral health needs. • In providing the safety net role we create a safe place for the private providers to function during the challenging times in people’s lives. • The small town culture of Grafton is welcoming and has supported many successful transitions, integrations and connections.
LSTC 17-19 Funding • Total Budget: $58,860,913 • General Fund: $28,478,830 • Federal Fund: $27,002,845 • Other: $3,379,238 • Daily Rate: $981.77 • In comparison to 37 other states with state operated large residential service programs, the LSTC compares around the median cost levels of states. • In comparison of quality, however ND LSTC is the only such agency currently accredited by the Council on Quality and Leadership on Services for People with Disabilities (CQL).
LSTC as Percent of Nat'l Avg Costs 92-13 (2013 most recent national data available in 2016) 180.0% 160.0% 158.6% Percent of Nat'l Avg Daily Rate 140.0% 143.0% 120.0% National Average of Similar Facilites 109.5% 114.4% 103% $535 $210 $258 $312 $381 $482 $408 $539 $650 $646 100.0% 107.0% 105% $715 97.0% 95% 95% 80.0% 89% 60.0% 40.0% 20.0% $333 $357 $369 $417 $394 $570 $430 $514 $615 $681 $740 0.0% 1992 1996 2000 2004 2005 2007 2009 2010 2011 2012 2013 Survey Years Avg % Nat'l Avg 4
LSTC Services Residential Community Outreach • • These specialized clinical Campus Residential : services are provided in the Secure Services, Health Services, Grafton community, as well as Behavioral Services, Youth all regions and many Transition Services communities state wide. • Home and Community Based – Clinical Assistance, Resources, Services : 11 and Evaluation Service (CARES) • Current ICF Census/Caseload: – DD Behavioral Health Services – CARES Clinic is a team of – Residential ICF/IIDD Adults: 54 professionals who specialize in – Residential ICF/IIDD Youth: 13 providing services to people with DD who have complex medical needs. 5
Comparison of ND Services to Other States In Our Region With State Operated Facilities • South Dakota -Redfield • Iowa Woodward Resource Center • There is one state operated facility that as of • State operated residential services on November 2016 served 127 people. campus as an intermediate care facility • SD does not currently provide outreach and serves approximately 184 people services for people in the community although they are exploring this option. • Home and Community Based service • There are three treatment programs : provider serves approximately 40 people – Program 1-Serves men with challenging • behaviors, Family Support Service – Program 2- Turtle Creek Youth Program, – Respite Care Program 3-provides services to a wide – In-home services range of people of varying ages and skill levels. • Specialty Services- on campus and – Program 3 serves men and women, statewide many of whom have very challenging behaviors requiring intensive supports • Community Outreach Services or who typically require a great deal of – Consultations assistance with daily living need – Time limited assessments on ICF Campus – Conferences and Training 6
Comparison of ND Services to Other States In Our Region • Wisconsin • There are 3 intensive treatment programs in three state operated facilities. Southern Wisconsin Center (SWC) serves all adults.-124 census; Central Wisconsin Center (CWC) serves younger children- about 200 census,. Northern Wisconsin Center (NWC) serves older children and adults. • There are 4 short term treatment programs that support the continuum of care. Part of a referral includes an assessment and attempt to consult to divert admission to more restrictive settings • CWC also has a medical short term unit • CWC has an specialized adaptive equipment clinic for community. • Currently do not accept community members for services on campus, but do discuss that opportunity as well as behavioral health/crisis consultation. 7
Life Skills & Transition Center data by demographics CURRENT DEMOGRAPHIC DATA 8
LIFE SKILLS & TRANSITION CENTER of ND DHS TRANSFORMATION: AVERAGE RESIDENTIAL PROGRAM CENSUS 1997-2016 160 149 149 147 144 141 140 140 139 140 134 131 126 123 123 120 120 104 PEOPLE IN RESIDENCE 100 90 85 80 63 60 60 60 40 19 19 19 20 13 13 13 12 8 7 5 3 3 3 3 0 YEAR OF CENSUS ICF/DD-Adult ICF/DD-Youth HCBS 9
LSTC Age Distribution 2011 vs 2016 60 50 40 30 20 10 0 21 and under 22-50 51-65 Over 65 2011 2016 10
Youth Admit/Discharge by Year 12 10 8 6 4 2 0 2009 2010 2011 2012 2013 2014 2015 2016 Admit Discharge 11
Life Skills & Transition Center data on diversion consultation of CARES Services CARES TEAM AND STAFF 12
CARES Team/Staff Services 2011-16 CARES Total Service Events CARES New Apps 250 30 25 200 New Applications Received Number of Service Events 20 150 15 100 10 50 5 0 0 2011 2012 2013 2014 2015 2016 2011 2012 2013 2014 2015 2016 Years CARES # of People Served Years 50 Number of People Service by CARES 45 40 35 30 25 20 15 10 5 0 2011 2012 2013 2014 2015 2016 Years 13
Life Skills & Transition Center data on statewide Applied Behavior Analyst services (includes Psychologists) DD BEHAVIOR HEALTH SERVICES 14
DD Behavioral Health Services Caseload 300 Service Highlights 250 Caseload 2016: 263 o Regions: All 8 o Providers: Over 20 200 o Communities: Over 30 Applied Behavior Analysts 150 o Positions: 6, 5 filled o Credentials: 100 o 3 Licensed ABA o 1 Registered ABA 50 o 4 BCBA Psychologists o 2 Doctoral Level 0 2010 2011 2012 2013 2014 2015 2016 15
Regional Behavioral Health Service Caseload Unduplicated - 2016 9 16 Of 234 35 people 25 served – 29 People were seen 29 by more 35 than one staff member 20 (on caseload of 2+). 65 NW (1) NC (2) LR (3) NE (4) SE (5) SC (6) WC (7) BL (8) 16
Life Skills & Transition Center data on statewide CARES Clinic and Adaptive Equipment services CARES CLINIC/AES 17
LSTC - AES COMMUNITY PROJECTS & LOANS Service Highlights by FISCAL YEAR Community Connections - PROJECTS LOANS FY 2014-2016 PROJECTS : 250 o Adults: 366 o Children: 76 194 o Facilities: 28 200 170 Total Connections/Projects: 470 Community PROJECTS & LOANS 150 Increase of LOANS is due in part to: increase in awareness, increase use of 106 AT4ALL (ND IPAT-partnership site which 100 79 offers access to adaptive technology reutilization), and changes in CMS 50 33 (Medicare) e.g. increased timeframe for obtaining equipment from community 2 0 suppliers. FY 2014 FY 2015 FY 2016
CARES Cli CA RES Clinic nic PT-OT PT OT-Spe Speec ech Service Highlights 1200 • Therapy Services includes the departments of Physical Therapy, 957 Occupational Therapy, and Speech Language Pathology. 1000 • For 2014-2016 Fiscal Years: 826 o Total People Served 800 Services Provided (Invoices) 720 (by discipline): 194 Adults: 102 600 Children: 92 o Total Services Provided : 2503 400 People seen who are not served by a DD provider are primarily children living at home and receiving early intervention services. 200 0 FY 2014 FY 2015 FY 2016
CARES Clinic Dental Services 80 74 70 60 Service Highlights 60 Services Provided (Invoices) 50 Total Services Provided 2014-2016: 179 45 40 30 20 10 0 FY 2014 FY 2015 FY 2016
CARES CAR ES Cli Clinic nic Medical Ser Med ical Service vices 134.5 134 134 133.5 Service Highlights 133 133 Services Provided (Invoices) Medical Services includes the 132.5 departments of Medical (DNP), Nutrition Services, LAB/X-Ray. 132 Total Services 2014-2016: 398 131.5 131 131 130.5 130 129.5 FY 2014 FY 2015 FY 2016
CARES CAR ES Cli Clinic nic Regio giona nal l Service Se vices: s: Undu Unduplica plicated ted AES, ES, PT PT, , OT, , SL SLT, , Med edical, ical, Den ental tal Service 160 Highlights 140 The CARES Clinic has 120 served people from every region but one 100 People Served Services generally use 80 integrated approaches combining several disciplines 60 Total People 2016 : 220 40 20 0 Reg 1 Reg 2 Reg 3 Reg 4 Reg 5 Reg 6 Reg 7 Reg 8
Transition to the Community Plan Overview and Data TRANSITION TO THE COMMUNITY 23
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