Script for Arkansas Vision
Welcome the audience—appreciate your taking time, etc.
Introduce yourself and your role
Introduce HP representatives
Introduce Gary and Sue—explain how it is a privilege to have Gary & Sue –international fame, etc.
Slide 1: Tell the audience you are here to talk about the Arkansas Vision—give them a sense of how we arrived at developing a statewide outcome system.
Slide 2: Beginning in August 2006, a stakeholder planning group was formed to understand System of Care and begin planning both services and outcomes. At that first meeting the outcome question asked was “What are we getting for the services we provide to children?’
The stakeholder planning group focused on setting up a system of care in Arkansas and included the following events.
- Act 1593 reviewed and encouraged by the group
- First Lady Ginger Beebe’s Statewide Listening Tour May 8 to July 3 2007 (19 cities throughout the state
The purpose of the listening tour was to give parents an opportunity to share their experiences, both positive and negative, about the Arkansas children’s mental health system
- Also in May 2007 an Outcome subcommittee of Stakeholders began meeting. Their goals included
- Tracking the progress on child or youth while in treatment ,and
- Collecting data on treatment effectiveness
Slide 3 & 4: ACT 1593 was passed at the legislative session in 2007, this act established the principles of a System of care (Note slide 3 is not included in the handouts.—this was so we could have a one page handout).
ACT 1593 established the Children’s Behavioral Healthcare Commission to oversee System of Care implementation.
- The ACT mandates an assessment tool to guide service decisions and outcomes
- It also authorizes an outcomes-based data system to track outcomes
- And it encourages family-driven, child-centered, youth guided services and systems
Slide 5: The Children’s behavioral healthcare commission established the Outcomes/Assessment Group which continued work of the Stakeholder outcome committee. This group was comprised of family members, mental health care providers, state agencies, professionals with knowledge of treatment and outcomes
Slide 6: The group began by developing a comprehensive list of all types of child/family outcomes. They wanted:
- Children/youth have ongoing successes at school.
- Children/youth receive behavioral health services in their communities
- Children/youth maintain healthy lifestyles.
- Children/youth have increased positive functioning:
- Families are actively engaged in and understand the ongoing treatment process concerning their children/youth. (Youth are engaged in decision making as appropriate).
- Children/youth exhibit reductions in symptom severity:
Slide 7: The outcomes workgroup looked at instruments that addressed these areas, and found up to 70 instruments, reviewed over 20 and narrowed the list to 7.
They constructed a matrix to look at 7 outcome instruments and also sent the list to stakeholders (who provided information and feedback
The workgroup then voted on the 7 and selected the top 4. The workgroup brought in the developers of these 4 for a presentation
YOQ (Youth Outcome Questionnaire)
CANS (Child and Adolescent Needs and Strengths)
CAFAS (Child adolescent Functional Assessment Scale)
And ATOM (Adolescent Treatment Outcome Module) developed by UAMS-PRI
Following the presentations, stakeholder group members ranked the instruments. The order was YOQ, CANS, CAFAS, and ATOM
Slide 8: In July, 2008 a committee from the Division of Behavioral Health Services, Division of Medical Services and HP was formed to review the instruments and to develop a strategy for developing a database with these instruments. Looked primarily at YOQ and CANS (top 2). Cans is in public domain, there was no database with this instrument, thus would have to develop one from scratch. The YOQ had a sophisticated database that could be purchased. Thus this was an easy choice.
Then obtained Federal Medicaid $$ to help purchase yearly access to the database and develop AR training and system.
Slide 9: This group met to develop YOQ rollout, by phone and face to face twice with the YOQ developers and OQ analyst to work out details of rollout in AR.
A pilot was held in Jonesboro in January; Feedback from this pilot was overall positive, parents liked the tool, providers found it fairly easy to use and helpful.
also in January was a Launch meeting to introduce the YOQ to all the Executive Directors of Mental health agencies (RSPMI providers)
Now Switch gears and talk about the AR Indicators
Slide 10: The AR Indicators were developed to address the Priority outcomes that stakeholders (parents, providers) wanted measured. Thus the AR Indicators covers several areas not addressed in the YOQ. These include success in school, community activities (to measure involvement in community), healthily life styles (using tobacco, alcohol), etc.
There are 11 outcome measures and 9 satisfaction questions (to find out if parents and youth are involved and satisfied with services)
Slide 11: There are 3 versions to match 3 version of the YOQ.
The parent version for all parents of kids 4-18, youth version for 12-18 year olds, and adult version for adults ages 18-21.
Some of the questions can definitely be used to inform the clinician of areas of treatment (including sexual abuse, bullied, involved in gangs).
Other information is more of a way to systematically gather data agency and statewide, for example—whether child is currently living at home or in another situation (with relatives, residential, etc).
Slide 12: How do you collect this information using the AR Indicators?
For children with a new episode of care, collect within 14 days (will be available on the OQ analyst)
For returning youth collect around time of treatment review.
Then collect every 90 days until discharge from agency.
Slide 13: If you need assistance with clinical questions regarding the AR Indicators or YOQ you may contact David Jones at