EVALUATION SUMMARY DECEMBER 11, 2014 Click to edit Master text - - PowerPoint PPT Presentation

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EVALUATION SUMMARY DECEMBER 11, 2014 Click to edit Master text - - PowerPoint PPT Presentation

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FY14 HeLP ANNUAL EVALUATION SUMMARY DECEMBER 11, 2014 Click to edit Master text styles Second level Third level Fourth level Fifth level EVALUATION COMPONENTS Professional Education Survey Referral Provider Surveys

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FY14 HeLP ANNUAL EVALUATION SUMMARY

DECEMBER 11, 2014

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EVALUATION COMPONENTS

  • Professional Education Survey
  • Referral Provider Surveys
  • HeLP Legal Services Clinic Student Satisfaction

Survey

  • HeLP Health Law Advocacy Student Survey
  • HeLP Clinic Case Rounds Survey
  • Fundamentals of Medicine Student Survey
  • Resident Longitudinal Survey
  • Client Surveys
  • Administrative Claims Analysis
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PROFESSIONAL EDUCATION EVALUATION

  • Suspended in FY13 and FY14 for curriculum

development

  • Only offered to New Residents at Hughes

Spalding

  • 16 residents completed survey post education

seminar

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OUTCOME INDICATORS

  • 94% affirmed they are more likely to advocate
  • n their patient’s behalf after attending HeLP

seminar

  • Satisfaction with the education seminar was

rated high among all respondents

  • All respondents reported they would

recommend participation in the education seminars to their colleagues.

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REFERRING PROVIDER SURVEY

  • 45 survey completed /

150 disseminated = Response rate of 30%

  • Respondents represent

Physicians (60%) and Social Workers (40%)

  • Top 5 Problems/Topics

for referral: SSI/Disability,

Family Law, Housing, Education & Public Benefits

77% 69% 82% 61% 74% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

HeLP's Ability to Assist Client with Referred Problem Percent Rated Excellent or Good

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OUTCOME MEASURES

87% 19% 28% 19% 89%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Positive Impact on Patient Health Reduce ED Visits Reduce Hospital Readmits Reduce Hospital LOS Perceptions of Working w Legal Community

Percent of Referring Providers who Responded Affirmatively

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PROCESS INDICATORS

62% 68% 53% 79% 65% 61%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

Commuication w Clients Communication w Health Care Providers Communication w Social Workers Provide Info. on Services Quality of Response Response Time to Calls

Percent of Referring Providers who Report Excellent or Good

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OPPORTUNITIES FOR IMPROVEMENT

  • Mechanism to provide feedback to providers

regarding HeLP referral

  • Opportunities to demonstrate program

effectiveness to referring providers

  • Mechanism to capture referring provider

contact information for survey administration

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HeLP CLINIC PARTICIPANT STUDENT SURVEY

  • 17 surveys completed of

34 disseminated = Response rate = 50%

  • Respondents represented

law (94%) and social work (6%) students

  • Top case types for

students include:

SSI/Disability, Housing, Education, Wills/AD & Public Benefits

100% 93% 100% 90% 92% 50% 55% 60% 65% 70% 75% 80% 85% 90% 95% 100%

HeLP's Ability to Assist Client with Legal Problem Percent Rated Excellent or Good

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OUTCOME INDICATORS

  • All respondents rated HeLP’s ability to meet

the legal needs of clients as Excellent or Good

  • 94% reported learning better professional

skills through their experience

  • 82% reported they are Definitely Likely or

Likely to remain involved in public services activities based on HeLP experience

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PROCESS INDICATORS

83% 88% 94% 100% 82%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Client Understanding of HeLP Education of Health Care and Social Services Staff Student Understanding of HeLP Provide Legal Resources Provide Referral Resources

Percent who Report Excellent or Good

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OPPORTUNITIES FOR IMPROVEMENT

  • Greater involvement of medical interns and

increasing their involvement with the program

  • Identify opportunities to increase survey

participant response rate

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HEALTH LAW ADVOCACY SURVEY

  • Pre/Post-survey non-comparative design

– Pre-survey: 6/9=67% response rate. Designed to gather qualitative information on participant expectations of class – Post-survey: 7/9=78% response rate. Designed to gather qualitative information on impact of class participation on knowledge, skills and perceptions

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OUTCOME INDICATORS

  • 86% reported high levels of satisfaction with

the course & all indicated it exceeded expectations

  • All reported the course helpful to developing

&/or enhancing professional skills

  • All found the course staff as helpful in

addressing questions and providing support in working with community partners

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PROCESS INDICATORS

  • Respondents reported that the legislation

proposed by the community partners was important to lawmakers.

  • Students noted that the public was interested in

the proposed legislation and two-thirds felt efforts to increase public support for the issues were effective.

  • Respondents noted that community partners

could have been more influential in impacting the attitudes and beliefs of policymakers and the public.

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MEDICAL EDUCATION SURVEYS

  • HeLP Legal Services Clinic Case Rounds

(Case Rounds)

  • Fundamentals of Medicine III (FOM III)
  • Resident Longitudinal Study (Resident

Study)

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HeLP CASE ROUNDS

  • 21 resident participants in 7 Case Rounds
  • Respondents:

– 41% 1st yr. residents – 23% 2nd yr. residents – 36% 3rd yr. residents

  • Case Round attendance:

– 48% attended 1x – 28% attended 2x – 24% attended 3x

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OUTCOME INDICATORS

  • 95% or more reported high and moderate levels of

awareness of how SEDH may effect low-income patients

  • 81% reported that incorporating lawyers on the

treatment team can be Extremely or Very Influential to providing patient care

  • 61% reported they are Very Likely or Likely to ask

patients if they are experiencing a legal problem

  • 52% of respondents reported they are Very Likely or

Likely to refer patient to legal resource

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OUTCOME INDICATORS

95% 95% 81% 81% 76% 71% 64% 49%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Education Income Medicaid/CHIP Health Insurance Public Benefits Housing Family Law SSI/Disability

Percent Very Likely or Likely to Screen for Problems

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OUTCOME INDICATORS

  • 90% of respondents indicated that participation

in Case Rounds was Very Important or Moderately Important to their clinical education experience

  • 62% agree that Case Round participation

positively affected their perception of interdisciplinary collaboration and practice

  • 86% agree that participation helped to develop

interdisciplinary skills

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FOMIII SURVEY

  • Pre-/Post-Survey Design
  • Response Rate:

– Pre: 34/59 = 58% – Post:30/59 = 48%

  • Cohort level comparison
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OUTCOME INDICATORS

34% 22% 14% 11% 8% 7%

0% 5% 10% 15% 20% 25% 30% 35% 40%

Public Benefits Transportation Health Insurance Income Family Stability Housing/Utilities

Pre-/Post Survey Percentage Point Increase in Awareness

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OUTCOME INDICATORS

27% 20% 16% 16% 11%

0% 5% 10% 15% 20% 25% 30%

Public Benefits SSI/Disability Education Family Law Income

Pre/Post Survey Percentage Point Increase in Likeliness to Screen

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OUTCOME INDICATORS

  • All survey respondents reported it is Important to

have knowledge of legal issues that effect the health and well-being of patients (+9%)

  • 87% reported that involving lawyers on the

treatment team can be Influential on providing patient care (+34%)

  • 87% reported they are Likely to refer to a legal

resource when aware that a patient is experiencing a socioeconomic or legal problem (+31%)

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RESIDENT LONGITUDINAL SURVEY

  • Administered to Pediatric Residents at

Children’s

  • Three surveys (Pre/Interim/Post) administered
  • ver three years

– Fall FY2012: 9/23=39% response rate – Spring FY2013: 9/23 = 39% response rate (7 matched respondents) – Spring FY2014: 13/23=57% response rate (6 matched respondents)

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  • YR. 3 POST-SURVEY

OUTCOME INDICATORS

  • 70% of residents reported the collaborative

interdisciplinary experience of working with HeLP to be Valuable

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3-YR LONGITUDINAL OUTCOME INDICATORS

  • All residents reported it Important to know of

resources to address patient legal problems (+11%)

  • 100% of residents noted it as helpful to have

access to lawyers in providing patient care.

  • Two-thirds of residents reported higher levels
  • f likeliness to refer patients to a legal

resource

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2-YR LONGITUDINAL OUTCOME INDICATORS

  • All respondents agreed that HeLP services

positively affected the health and well-being of patients (+45%)

  • 83% of residents reported that HeLP educational
  • pportunities were influential in shaping

perceptions of how legal problems impact the health of patients (+33%)

  • 100% reported an increased understanding of the

relationship among poverty, health and patient compliance (+34%)

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CLIENT SURVEYS

  • 654 cases were

reviewed for eligibility

  • r provided legal

services

  • 355 were accepted for

public health legal services (54%) & completed pre-survey

  • Referrals primarily
  • riginate from hospitals

25% 30% 26% 6% 6%

Clients by Intake Location

Hughes Spalding Egleston Scottish Rite Clinic Marcus Institue

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PRE-SURVEY RESULTS

  • 78% of clients rate their

financial well-being as Fair or Poor

  • 66% rate their physical

health as Good or Fair

  • 60% rate their emotional

health as Good or Fair

  • 70% rate their overall

well-being as Good or Fair

0% 5% 10% 15% 20% 25% 30% 35% 40% 45%

Excellent Good Fair Poor Don't Know No Response

Client

Financial Physical Emotional Overall Well-being

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PRE-SURVEY RESULTS

  • 55% of clients rated

dependent physical health as Good or Fair

  • 60% rated dependent

emotional health as Good or Fair

  • 61% rated dependent
  • verall well-being as

Good or Fair

0% 5% 10% 15% 20% 25% 30% 35% 40%

Dependent

Physical Emotional Overall Well-being

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CLOSED CASES

  • The most common case

types: Family Law, Housing, Disability, Education &Medicaid/CHIP

  • 47% of closed cases

result in legal self help and community referrals.

  • 33% result in an other

external referral + self help &/or community referral

14% 49% 22% 28% 23% 5% 19% 7% 25% 18% 7% 18% 7% 6% 12% 0% 20% 40% 60% 80% 100%

Self-help/Community referral (n=154) Other External Referral w Self-help/Community Referral (n=107) Extended Services (n=65)

Top 5 Case Types by Services

Family Law Housing Disability Eduation Medicaid/CHIP

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POST-SURVEY

  • 45 of the 65 cases were contacted for post-

surveys

  • 25 surveys were completed by clients (56%)
  • 20 surveys were not completed due to

inability to contact client or client refusal (44%)

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POST-SURVEY RESULTS

  • Most common case types
  • f completed surveys

– Education – Disability/SSI – Family Law – Medicaid/CHIP – Wills/Estates – Public Benefits

  • All rated their satisfaction

with services as Excellent

  • r Good

32% 20% 16% 12% 12% 8% Education Disability/SSI Family Law Medicaid/CHIP Wills/AD/Estates Public Benefits

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OUTCOME INDICATORS (1)

  • 88% of clients said they would be better able

to handle similar problems in the future

  • 84% reported that services had a positive

impact on the family’s financial situation

  • 56% reported HeLP services allowed their

child to spend more time in school

  • Of the 13 employed clients surveyed, 62%

were able to spend more time at work

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OUTCOME INDICATORS (2)

  • 64% of clients reported that services received

from HeLP improved their and their child’s physical health

  • 88% of clients reported that HeLP services

improved their emotional health & 68% reported services improved their child’s emotional health

  • 88% reported that HeLP services improved their

and their child’s overall well-being

  • 80% of respondents rated their overall

satisfaction with HeLP as Excellent & 15% rated Good.

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PROCESS INDICATORS (1)

  • 100% of post-survey respondents rated

Excellent or Good

– the way they were treated when they contact the program – Staff’s efforts to keep them informed on their case – Referrals to other agencies (n=9)

  • 96% of respondents rated the explanation of

services as Excellent or Good

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PROCESS INDICATORS (2)

  • All indicated they would contact the program

again for additional legal services

  • Suggestions for improvement – expand mode
  • f contact to email & increase office hours to

make it easier for clients to reach staff

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MATCHED SURVEY RESULTS (1)

29% 57% 50% 29%

0% 10% 20% 30% 40% 50% 60%

Financial Physical Emotional Overall Well-being

Percent of Clients who Rated Better Status on Post-Survey

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MATCHED SURVEY RESULTS (2)

27% 53% 50%

0% 10% 20% 30% 40% 50% 60%

Physical Emotional Overall Well-being

Percent who Rated Child's Status as Better on Post-Survey

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CHILDREN’S ADMINISTRATIVE DATA ANALYSIS

  • Pre/Post HeLP intervention utilization, charge and

paid data analyzed

  • Request submitted for any accepted case with a

valid HIPAA authorization for data exchange

  • Children’s provided data for 18 of 24 requested

cases

  • 8 of the 18 cases were still active at the time of

the evaluation

  • Case types: Family Law, Health Insurance

Coverage (Medicaid, CHIP, Private), SSI/Disability

  • r other health cases
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SUMMARY OF FINDINGS

  • Customer service among program participants and

stakeholders remains high

  • Legal services result in improved physical, emotional

health, and financial and overall well-being of clients and their children

  • Clients feel they are better able to deal with similar

problems in the future

  • Referring providers indicate that services allow them to

reallocate time to other patients and approximately 20% feel services result in reduced health care utilization

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SUMMARY OF FINDINGS

  • Working with HeLP positively impacts non-legal

professionals’ perceptions of working with attorneys to address health issues and improve health

  • HeLP educational offerings result in increased knowledge

about interprofessional collaboration and practice change.

  • Students report their experience with HeLP results in

developing and/or enhancing professional skills

  • Medical students and residents report increased awareness
  • f and likeliness to screen for socioeconomic determinants
  • f health (SEDH)
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OPPORTUNITIES FOR IMPROVEMENT

  • Implementing a mechanism to track referral

information for referring provider follow-up and survey administration

  • Exploring methods to increase participation

across all surveys

  • Ensuring continuity in data entry in the CMDS
  • Demonstrating and communicating program

effectiveness to stakeholders

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Susan McLaren, MPH, FACHE Georgia Health Policy Center Georgia State University 404.413.0076 smclaren@gsu.edu www.gsu.edu/ghpc

THANK YOU