Outpatient Annual Report

Corry Counseling of LECOM Health

Mental Health Outpatient Program

FY 2021/2022 Annual Program Report

Program Description

Corry Counseling of LECOM Health (CCLH) provides outpatient mental health services to Erie, Warren and Crawford County children and adults. The population includes individuals with severe mental illness and others with less severe emotional disorders.

Outpatient services include screening and assessment, safety planning, psychiatric evaluation, individual psychotherapy, group therapy, children’s play therapy, family therapy and medication management. For those accepted for outpatient services, an individual treatment plan is developed based on the needs as identified in the intake process. All treatment plans are developed under the supervision of the consulting psychiatrist and clients are seen for psychiatric evaluation and services as indicated. All clients accepted for service are registered with Erie County Care Management and/or Health Choices provider. Children, who comprise approximately 33% of the agency’s total caseload, may be served in school at Columbus Area Intermediate. School-based hours have been adjusted due to continued restrictions and precautions related to the Covid-19 pandemic.

Consumer Satisfaction is monitored in partnership with the Mental Health Association of Erie County, in addition to agency client surveys.

Telehealth allowed for the psychiatrist to maintain continuity of care from alternative locations to a rural population during the winter months. Telehealth appointments by the psychiatrist, CRNP, and other OP staff members were also provided when there were exceptional circumstances. However, in-person appointments continue to remain the preferred method of service delivery.

The Outpatient Department was able to provide individuals with an initial psychiatric evaluation appointment within 7-10 days after completing their intake appointment.

Staff

During this fiscal year, outpatient staff was comprised of 3 full-time therapists, 3 full-time psychiatric nurses, 1 psychiatrist, 1 CRNP, and 1 Director of Outpatient Services. Transitions in employment took place beginning January 2022 with the outpatient director assuming the role of executive director, one full-time therapist moving into the outpatient director role, and the hiring of a full-time licensed therapist in February 14^th to fill the full-time therapist opening. The retention rate for therapists and nurses was 100%. Outpatient staff remained at full capacity throughout the entire fiscal year.

Training

An annual training plan was developed for the Outpatient program. Licensed therapists were to work to complete required continued education units toward 2/28/23 licensure renewal. Nursing staff completed required continued education units for 2021/2022 licensure renewal. Additional training goals for this year were for staff to complete the following Relias Trainings: Introduction to Motivational Interviewing, Working More Effectively with the LGTBQ+ Community, Fire Safety, and Corporate Compliance Annual training. Outpatient staff was to also complete 6 hours of training in an area of interest.

Outpatient staff met 100% of annual training goals for this fiscal year. Therapists and the Director of Outpatient furthered their professional development by completing trainings in The Clinician’s Suicide Prevention Summit: Treatment Strategies to inspire Hope and Save Lives, 5th Annual Older Adult Mental Health Awareness Day Symposium. All of the staff completed Emergency Response Procedures held at CCLH. The new therapist staff hired February 2022 successfully completed the required trainings checklist within the 90 day probationary period.

The training goals for Outpatient staff for the upcoming fiscal year include completion of the following trainings: Trauma-Informed Care: Implications for Clinicians and Peer Support Specialists, Application of HIPAA in Behavioral Health, Suicide-Specific Interventions and Best Practices, Supporting Adults in the Grieving Process, Introduction to Psychopharmacology.

Therapists will also be completing Ethics for Counselors. An additional 6 hours of training for individual professional development will be chosen by individual staff members.

Clients

The Outpatient Program served 1498 individuals this fiscal year. There were 667 intakes completed, of which 432 were adult assessments and 235 were child/adolescent assessments. There were 558 case closures. There were no specific concerns regarding referrals. Of those 1498 individuals, 1413 were Caucasian, 37 were African American, 22 were Hispanic, 2 were Native American, 4 were Asian, 1 was Pacific Islander and 20 were other. 810 were female clients and 688 were male clients. There were 14 clients ages 0-5, 269 clients ages 6-13, 207 clients ages 14-17, 213 clients ages 18-25, 438 clients ages 26-45, 256 clients 46-64 and 101 clients ages 65 and older.

Productivity

The target goal for outpatient clients to attend their psychiatric evaluation was 95%. 87% of psychiatric evaluation appointments were kept this year. Productivity continues to not be measured for the outpatient clinicians, as they have consistently met and/or exceeded their productivity standard of 75% over the last several years. The psychiatric nurses also have an expectation of 75% productivity. All of the nursing staff met or exceeded their expected number of medication appointments and Complex Case Coordination units.

Licensure Visits and Quality Audit

The annual licensure visit was completed on 06/09/2022. No recommendations, citations, or plans of correction were issued. Fraud, Waste and Abuse and Quality Audits were not conducted for Outpatient during this fiscal year.

Client Satisfaction Survey Results

Client satisfaction surveys were conducted in January 2022. A total of 205 surveys were completed and returned. In addition to the five statements to which all agency clients were asked to respond, there were two specific statements for OP clients. Not all respondents answered all questions and question 7 in regard to medication education was only to be answered by those prescribed medication. 93% of the respondents agreed with statement 7: “The purpose and side effects of my medications were explained to me”. 96% of clients agreed or strongly agreed with the following statement: “I have confidence in the ability of staff here to help me.”

Outcome Results

The revised target outcome for this fiscal year is 85% of clients who are identified as depressed by the PHQ-9 or PHQ-A will have an improved score after 2 or more consecutive medication appointments, with 50% of those have a decrease of 25% or more. There were a number of variables that impacted the complete collection of data, such as clients dropping out of treatment, clients cancelling and rescheduling appointments, change in the prescriber’s schedules. The outcome results were as follows based on data that was able to be collected: There were a total of 390 PHQ-9 and PHQ-A questionnaires completed at the initial psychiatric evaluation appointment for this fiscal year. Of that 390, only 175 individuals returned their questionnaires for 2 consecutive medication appointments or more. 82% of those individuals had an improved PHQ score at their second (or most recent) medication appointment. Of those individuals who had an improved score, 51% had an improved score of 25% or more.

A new outcome goal for FY2021/22 was “95% of clients who complete the client satisfaction survey report receiving and understanding medication education.” Of the clients surveyed, 93% reported receiving and understanding medication education.

Expectations for the coming year

One goal is to achieve a 95% or greater attendance rate for psychiatric evaluations. Clients will continue to be contacted by telephone and/or letter to support their appointment attendance and resolve barriers to attendance. Telepsychiatry services will continue to be utilized during the 2022/2023 fiscal year.

Another goal is to add 1 full-time therapist to the outpatient setting. Additional clinical staff will enhance Outpatient Services being provided in both the clinical and school setting.