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Oklahoma Health Care Authority ECHO® Child Behavioral Health Survey for SoonerCare Choice Executive Summary and Technical Specifications Report for Contract: State Fiscal Year 2010 Data Reviewed: December 1, 2008 – November 30, 2009 Submitted: June 2010 Submitted by: APS Healthcare 4545 North Lincoln Boulevard Suite 24 Oklahoma City, Oklahoma 73105 (405) 556-9700 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 2 ECHO® Child Behavioral Health Survey for SoonerCare Choice Executive Summary The Oklahoma Health Care Authority (OHCA) is the state’s single agency responsible for administering Medicaid. The managed care component of this program is known as SoonerCare Choice, which operated under a partially capitated case management system during the first half of state fiscal year (SFY) 2009. A patient-centered medical home model was implemented January 1, 2009. In order to evaluate service satisfaction, the OHCA contracted with APS Healthcare (APS) to survey children enrolled in SoonerCare Choice who accessed outpatient behavioral health services between December 1, 2008, and November 30, 2009. This survey is conducted annually alternating between the adult and child populations. Comparing the 2008 survey and the 2010 survey, results indicated fairly high levels of satisfaction holding steady across an array of 21 quality measures. One measure showed a statistically significant difference between 2008 and 2010: • The composite measure “As far as you know did anyone your child saw for counseling or treatment share information with others that should have been kept private?” had a significant decrease of members who reported “yes” from 6.7% in 2008 to 2.8% in 2010. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 3 ECHO® Child Behavioral Health Survey for SoonerCare Choice Technical Specifications Consumer satisfaction surveys are an important source of information to consumers, purchasers of health care, health plans and program administrators. By responding to satisfaction surveys, individuals provide valuable information regarding access to care, use of services, and satisfaction with the care they have received. The practice of surveying the general population of managed care members about their overall experience with their health plan has extended to surveying special populations. This special population survey detailed responses of members enrolled in SoonerCare Choice who received outpatient behavioral health services through the SoonerCare program. The Oklahoma Health Care Authority (OHCA) is the state’s single agency responsible for administering Medicaid. The managed care component of this program is known as SoonerCare Choice, which operated under a partially capitated case management system during the first half of the state fiscal year (SFY) 2009. A patient-centered medical home model was implemented January 1, 2009. Behavioral health services are available to SoonerCare Choice members. In order to evaluate service satisfaction, the OHCA contracted with APS Healthcare to survey members enrolled in SoonerCare Choice who accessed outpatient behavioral health services between December 1, 2008, and November 30, 2009. This technical report includes information on the survey methodology, findings, and summary information on the respondents’ satisfaction with behavioral health services received. The OHCA annually administers the Experience of Care and Health Outcomes (ECHO) survey, version 3.0, to measure members’ satisfaction with behavior health services. The methodology for this survey was based on the Consumer Assessment of Healthcare Providers Systems (CAHPS®). The CAHPS surveys, administration protocol and survey analysis were developed by Harvard, RAND and the Research Triangle Institute. The ECHO survey was developed by behavioral health consumers, clinicians and behavioral health policy experts, including representatives from the National ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 4 Committee for Quality Assurance’s (NCQA) Behavioral Health Measurement Advisory Panel, the Center for Mental Health Services, and the National Alliance for the Mentally Ill. On alternating years the OHCA surveys adults about their experiences with behavioral health treatment and parents/guardians about their children’s behavioral health care. For SFY 2010 the survey focused on services provided to children; comparisons were made with results from SFY 2008, the last year during which SoonerCare Choice children were measured by the ECHO survey. Method The Child ECHO Health Plan survey 3.0 questionnaire (shown in Appendix A) was administered by The Myers Group (TMG) between December 1, 2009, and March 31, 2010. The survey covered several aspects of behavioral health services, including: • Access to care • Receiving care without long waits • Communication with clinicians • Family involvement in care • Perceived improvement in functioning • Patient’s rights • Experiences with the health plan The questionnaire also asked respondents to give overall ratings of the counseling or treatment they received and SoonerCare Choice. Sampling Because it was not feasible to survey the entire SoonerCare Choice population, recognized sampling techniques were used to obtain information from a limited number of members. This information was used to estimate the consumer satisfaction of the SoonerCare Choice population as a whole. Sampling and fielding of the survey was conducted by subcontract with a nationally certified CAHPS survey firm, TMG. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 5 Sampling for this survey followed CAHPS 3.0 protocols. APS provided TMG with a list of eligible members for sample selection. Each member included in the eligibility list met the following criteria: • 17 years of age or younger as of November 30, 2008; • Enrolled in the SoonerCare Choice program as of November 30, 2009 and • Continuously enrolled in SoonerCare Choice for 12 months between December 1, 2008, and November 30, 2009. (Continuous enrollment was defined as having no more than one 45-day break in enrollment during the year.) In addition, APS limited the pool of members to those who had paid claims for outpatient behavioral health services between December 1, 2008, and November 30, 2009, in hopes of improving response rates. In accordance with CAHPS recommendations and to reduce the burden on respondents, TMG randomly selected only one member from a household for the sample. The ECHO Survey and Reporting Kit 3.0 standards indicate that a minimum of 411 completed surveys were needed for a valid administration. Estimating a response rate of 40% and adjusting 15% for the underreporting of behavioral health services received, the recommended sample was 1,183 members. The total number of SoonerCare Choice members eligible for the survey was 17,202; TMG selected a random sample of 2,000 members. Data Collection The CAHPS survey methodology allowed data to be collected by mail, telephone interview, or a combination of mail and telephone. The OHCA and APS agreed to conduct the survey using mail, and incorporated telephone interviewing only when the targeted response rate was not received. The survey process had six outreach interventions that included mailings of the survey packet, reminder postcards, and phone follow-up with bilingual interviewers. After the sample was selected, address lists were processed using the U.S. Postal Service’s CASS Certified ZIP + 4 Coding Software, which verified the zip code for each address. Each packet included a questionnaire and a letter that explained the purpose and ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 6 the importance of the survey. To encourage participation, the packet also contained a postage-paid business reply envelope. Reminder postcards served to thank individuals who had responded to the survey and to remind others to complete their questionnaires. Members selected for the sample who did not respond to the first survey and/or postcard mailings were mailed a second survey. All correspondence included a toll-free number that members could use to contact TMG with questions regarding the survey or to complete the survey over the telephone. Each information letter contained a statement written in Spanish asking the member to call the toll-free number to take the survey by phone with a Spanish interpreter. If needed, follow-up calls were then initiated with bilingual interviewers. TMG developed a database to track the status of members selected for the sample at each stage of the survey protocol. The database identified members who had not returned the survey and needed subsequent mailings. The database also indicated the date that a member responded to the survey, refused to participate in the survey, or was determined to be ineligible for the survey. Members were determined to be ineligible for the survey if they no longer qualified for SoonerCare or had moved to a another state. The criteria for determining a complete ECHO survey was taken from Article X of the CAHPS Survey and Reporting Kit entitled, “Determining a Complete ECHO Questionnaire.” According to those criteria, if 9 of 18 key items were appropriately answered, the survey was considered complete. Only surveys that met these criteria were included in the analysis. Data Coding and Data Entry TMG recorded the responses to the questionnaires in a database specifically designed for this purpose. The data entry program permitted the entry of only those responses that were within the accepted range for each specific item; for example, if a rating was supposed to be on a scale of 0 to 10, a response of 12 could not be entered. APS performed a data clean-up process prior to the actual analysis to detect any additional out-of-range values and response inconsistencies. Typically, inconsistencies occurred when respondents did not follow the skip pattern of question groups. Whenever ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 7 feasible, APS recoded the items to conform to the questionnaire skip patterns; for example, if one response indicated the person did not receive forms to fill out, then any subsequent responses to questions about the ease of completing the forms were discarded. However, when the intent of the respondent could not be determined, the analyst recoded the item as missing. Data Analysis All analyses and calculations in the study were performed by APS using SAS Version 9.1. Frequencies were computed for all the items on the survey. Due to the lengthy results for this type of descriptive statistics, the frequency distributions are reported in Appendix B rather than in the results section. The main analysis compared this year’s survey results with those from the previous administration of the survey, which was in SFY 2008. This analysis produced three types of results: global ratings, composite measures, and individual items. Global ratings, which used a scale of 0 to 10, measured the respondents’ assessment of their health plan and the quality of the care received. APS computed the means for each global rating and used t-tests to compare means from the SFY 2008 and SFY 2010 SoonerCare Choice surveys. The two global ratings compared were: • Overall rating of treatment or counseling received by the child • Overall rating of the health plan. Composite measures combined the responses to questions that were closely related to each other and provided more comprehensive and meaningful results than comparing each item separately. APS computed the mean scores for each composite and used t-tests to compare means from the SFY 2008 and SFY 2010 SoonerCare Choice surveys. The five composite measures were compared were: • Experiences in getting treatment quickly • Experiences with how well clinicians communicate • Experiences in getting treatment and information from the plan • Perceived improvement from treatment ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 8 • Availability of professional help and support Individual items provided meaningful results concerning specific issues. For items with multiple responses, APS computed the mean scores for each individual item and used t-tests to compare results from the SFY 2008 and SFY 2010 SoonerCare Choice surveys. For items with dichotomous “yes/no” responses, APS computed chi-squared tests to compare results. The individual items that could be compared were: • Appointment waiting time • Amount child was helped by treatment • Informed about medication side effects • Discussed goals of treatment • Discussed treatment options • Informed about condition management • Informed about patient rights • Ability to refuse treatment options • Health information privacy • Responsiveness to cultural needs • Reasons for seeking treatment Results Table 1 shows the response by method for the current year’s survey and the previous administration of the survey in SFY 2008. Table 1. Completed Survey Response by Method and Year Completed Surveys SFY 2010 Survey SFY 2008 Survey Mailing 519 433 Phone Follow-Up 114 114 Total Completed Surveys 633 547 The study evaluated each returned questionnaire to determine if it met the CAHPS definition for a completed survey. To be considered complete, a questionnaire must have had appropriate responses to at least nine of 18 key questions identified by CAHPS. APS ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 9 coded returned questionnaires that did not pass the completion criteria as non-respondents and excluded them from the analysis. During SFY 2010, 380 surveys were deemed ineligible due to not meeting the criteria for completion. Table 2 shows the number of ineligible survey respondents by disposition. Table 2. Number of ineligible surveys for SFY 2010 Ineligible Disposition N % Did not meet criteria for completion 380 100% Total Ineligibles 380 100% The adjusted response rate, expressed as a percentage, is the number of completed surveys divided by the number of eligible surveys. Number of completed surveys Number of eligible surveys x 100 = Adjusted response rate (Total completed surveys) 633 (Sample) –(Ineligible) = 2000 – 380 x 100 = 39.1% The adjusted response rates for the current SoonerCare Choice survey was 39.1%; the adjusted response rates for the previous SoonerCare Choice survey was 32.0%. The difference in response rates probably is attributable to the decision in SFY 2010 to limit the sampling frame to participants who had a paid claim with a behavioral health provider during the sample timeframe. Demographics Respondents were asked their race and ethnicity. Figure 1 shows the results. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 10 Figure 1. ECHO Respondents’ Racial Identity Caucasian 61.3% American Indian 10.4% Multiracial / Other 18.0% Asian 0.2% African American 10.2% Results showed that the majority of participants (61.3%) were Caucasian. African Americans and American Indians were equally represented (10% each), and the remaining members reported another race or multiple races. In response to a separate question about ethnicity, 9.9% of respondents reported to be Hispanic or Latino. Global Ratings In Figures 2 and 3, the overall ratings are shown for the following: • Overall rating of treatment or counseling received • Overall rating of the health plan providing behavioral health services The means for the global rating items for the two years are shown in bar graphs. The table below each graph lists the number of respondents analyzed, the means, and the p-value associated with the statistical comparison between the two years, using a t-test. A p-value less than .05 was considered statistically significant. That is, if the p-value was less than .05, the two means were statistically different from each other; otherwise, the two means were not statistically different.* * APS used SAS PROC TTEST to compute the significance of difference between years. Reported p-values are from pooled tests with equal variances assumed: no items failed a test of equal variances. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 11 Overall Rating of Treatment or Counseling Received • Using any number from 0 to 10, where 0 is the worst counseling or treatment possible and 10 is the best counseling or treatment possible, what number would you use to rate all your child’s counseling or treatment in the last 12 months? Figure 2. Overall Rating of Treatment or Counseling Received 7.83 7.84 0 1 2 3 4 5 6 7 8 9 10 2008 2010 Mean Figure 2 demonstrates that SoonerCare Choice members remained fairly satisfied with the counseling and treatment received in 2010 compared with the ratings in 2008. The slight increase was not statistically significant. Year N Mean p-value 2010 620 7.84 2008 287 7.83 .9371 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 12 Overall Rating for Health Plan on Providing Behavioral Health Services • Using any number from 0 to 10, where 0 is the worst health plan possible and 10 is the best health plan possible, what number would you use to rate your child’s health plan for counseling or treatment? Figure 3. Overall Rating for Health Plan on Providing Behavioral Health Services 8.19 8.20 0 1 2 3 4 5 6 7 8 9 10 2008 2010 Mean Year N Mean p-value 2010 616 8.20 2008 349 8.19 .9910 Figure 3 shows that SoonerCare Choice members were satisfied with the provision of behavioral health services in 2010. The slight increase from 2008 was not statistically significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 13 Composite Measures In Figures 4 through 8, the following composite measures are provided: • Experiences in getting treatment quickly • Experiences with how well clinicians communicate • Experiences in getting treatment and information from the plan • Perceived improvement from treatment • Availability of help and support The percentage in each category for the composite measures is shown in the bar graph. The table below each graph lists the number of respondents analyzed, and the mean and the p-value associated with the statistical comparison between the two years. The smallest categories are combined for display purposes only, so that percentages can be shown for each category in the graph. See footnotes below each table on how recoding was performed. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 14 Getting Treatment Quickly • In the last 12 months, how often did you get the professional counseling your child needed on the phone? • In the last 12 months, when your child needed counseling or treatment right away, how often did he or she see someone as soon as you wanted? • In the last 12 months, not counting times your child needed counseling or treatment right away, how often did your child get an appointment for counseling or treatment as soon as you wanted? Figure 4. Getting Treatment Quickly 31.50% 32.71% 24.64% 23.50% 43.86% 43.79% 0% 20% 40% 60% 80% 100% 2008 2010 Never/Sometimes Usually Always Year N Mean* p-value 2010 549 3.00 2008 294 3.01 .3195 * Responses of “Never” and “Sometimes” were recoded to 1, responses of “Usually” were recoded to 2 and responses of “Always” were recoded to 3. Figure 4 shows that 67.3% of the respondents in 2010 reported usually or always receiving treatment quickly. This was a decrease from 2008 when 68.5% of respondents reported usually or always receiving treatment quickly. The mean difference was not statistically significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 15 How Well Clinicians Communicate • In the last 12 months, how often did the people your child saw for counseling or treatment listen carefully to you? • In the last 12 months, how often did the people your child saw for counseling or treatment explain things in a way you could understand? • In the last 12 months, how often did the people your child saw for counseling or treatment show respect for what you had to say? • In the last 12 months, how often did the people your child saw for counseling or treatment spend enough time with you? • In the last 12 months, how often were you involved as much as you wanted in your child’s counseling or treatment? Figure 5. How Well Clinicians Communicate 11.63% 19.56% 68.81% 11.54% 21.04% 67.42% 0% 20% 40% 60% 80% 100% 2008 2010 Never/Sometimes Usually Always Year N Mean* p-value 2010 633 3.53 2008 290 3.55 .8788 * Responses of “Never” and “Sometimes” were recoded to 1, responses of “Usually” were recoded to 2 and responses of “Always” were recoded to 3. Figure 5 shows that 88% of members felt that clinicians usually or always communicated well during 2010, the same as 2008. The mean difference was not significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 16 Access to Treatment and Information from the Health Plan • Since your child joined this health plan, how much of a problem, if any, was it to get someone for your child you are happy with? • In the last 12 months, how much of a problem, if any, were delays in counseling or treatment while you waited for approval from your child’s health plan? • In the last 12 months, how much of a problem, if any, was it to get the counseling or treatment you thought your child needed? • In the last 12 months, how much of a problem, if any, was it to find or understand information (about counseling or treatment)? • In the last 12 months, how much of a problem, if any, was it to get the help you needed for your child when you called the health plan’s customer service? • In the last 12 months, how much of a problem, if any, did you have with paperwork for your child’s health plan? Figure 6. Access to Treatment and Information from the Health Plan 24.25% 23.89% 66.56% 65.99% 9.18% 10.12% 0% 20% 40% 60% 80% 100% 2008 2010 Big Problem Small Problem Not a Problem Year N Mean p-value 2010 618 2.56 2008 351 2.57 .6891 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 17 Figure 6 demonstrates that 89.9% of respondents indicated no problem with access to treatment and information in 2010, compared with 90.8% in 2008. The mean difference in average ratings was not statistically significant. Perceived Improvement from Treatment • Compared to 12 months ago, how would you rate your child’s ability to deal with daily problems now? • Compared to 12 months ago, how would you rate your child’s ability to deal with social situations now? • Compared to 12 months ago, how would you rate your child’s ability to accomplish the things he or she wants to do now? • Compared to 12 months ago, how would you rate your child’s problems or symptoms now? Figure 7. Perceived Improvement from Treatment 31.63% 32.81% 42.66% 38.35% 20.42% 22.43% 5.3% 6.4% 0% 20% 40% 60% 80% 100% 2008 2010 Much Better A Little Better About the Same A Little/Much Worse Year N Mean* p-value 2010 627 2.04 2008 359 2.01 .6213 * Responses of “Much better” were recoded to 1, responses of “A little better” were recoded to 2, responses of “About the same” were recoded to 3, responses of “A little worse” and “Much worse” were recoded to 4. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 18 Figure 7 shows that 71.2% of respondents in 2010 believed their child was “much better” or “a little better”, compared with 74.3% in 2008. The mean difference was not statistically significant. Availability of Help and Support • In the last 12 months, how often did your family get the professional help you wanted for your child? • In the last 12 months, how often did you feel your child had someone to talk to for counseling or treatment when he or she was troubled? Figure 8. Availability of Help and Support 19.41% 17.06% 26.05% 24.66% 54.55% 58.28% 0% 20% 40% 60% 80% 100% 2008 2010 Never/Sometimes Usually Always Year N Mean* p-value 2010 627 3.36 2008 288 3.31 .4424 * Responses of “Never” and “Sometimes” were recoded to 1, responses of “Usually” were recoded to 2 and responses of “Always” were recoded to 3. Figure 8 shows that 82.9% of respondents in 2010 believed their child “usually” or “always” had professional help and support available, compared with 80.6% in 2008. The difference of means was not statistically significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 19 Single Item Measures Figures 9 and 10, and Table 2 compare results for the following single item measures: • Appointment waiting time • Amount child was helped by treatment • Informed about medication side effects • Discussed goals of treatment • Discussed treatment options • Informed about condition management • Informed about patient rights • Ability to refuse treatment options • Health information privacy • Responsiveness to cultural needs • Reasons for seeking treatment Table 2 contains the percentage who answered “yes” to yes/no questions in 2008 and 2010, as well as the p-value for a statistical chi-squared test of the difference between years. Differences with p-values of .05 or less are considered statistically significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 20 Appointment Waiting Time • In the last 12 months, how often was your child seen within 15 minutes of his or her appointment? Figure 9. Appointment Waiting Time 23.71% 25.81% 33.33% 29.68% 42.96% 44.52% 0% 20% 40% 60% 80% 100% 2008 2010 Never/Sometimes Usually Always Year N Mean* p-value 2010 620 3.09 2008 291 3.10 .8197 * Responses of “Never” and “Sometimes” were recoded to 1, responses of “Usually” were recoded to 2 and responses of “Always” were recoded to 3. Figure 9 shows that 74.2% of respondents in 2010 said their child “usually” or “always” was seen within 15 minutes, compared with 76.3% in 2008. The difference of means was not statistically significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 21 How Much Your Child was Helped • In the last 12 months, how much was your child helped by the counseling or treatment he or she got? Figure 10. How Much Child was Helped 20.96% 18.81% 28.90% 32.15% 50.14% 49.04% 0% 20% 40% 60% 80% 100% 2008 2010 Not at all/A little Somewhat A lot Year N Mean* p-value 2010 622 3.25 2008 353 3.23 .6856 * Responses of “Not at all” and “A little” were recoded to 1, responses of “Somewhat” were recoded to 2 and responses of “A lot” were recoded to 3. Figure 10 shows that 81.2% of respondents in 2010 said their child was helped “somewhat” or “a lot”, compared with 79.0% in 2008. The difference of means was not statistically significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 22 Table 3. Percent Responding “Yes” to Single-Item Measures Item SFY 2008 SFY 2010 p-value Were you told what side effects of those medicines to watch for? 80.30% 80.57% .9337 Were the goals of your child’s counseling or treatment discussed completely with you? 89.55% 88.22% .5563 Were you given information about different kinds of counseling or treatment that are available for your child? 62.11% 64.25% .5331 Were you given as much information as you wanted about what you could do to manage your child’s condition? 73.17% 74.15% .7546 Were you given information about your child’s rights as a patient? 88.61% 90.06% .5077 Did you feel you could refuse a specific type of medicine or treatment for your child? 87.06% 87.68% .7936 As far as you know did anyone your child saw for counseling or treatment share information with others that should have been kept private? 6.67% 2.78% .0058* Was the care your child received responsive to those (cultural) needs? 75.00% 76.92% .8908 Was any of your child’s counseling or treatment for problems related to ADHD or other behavior problems? 77.90% 81.73% .1481 Was any of your child’s counseling or treatment for family problems or mental or emotional illness? 66.76% 67.91% .7146 Was any of your child’s counseling or treatment for autism or other developmental problems? 20.00% 22.30% .4044 Was any of your child’s counseling or treatment for help with alcohol use or drug use? 5.16% 4.21% .4958 * Statistically significant ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 23 Discussion Comparing the SFY 2008 survey and the SFY 2010 survey, results indicated relatively high levels of satisfaction holding steady across an array of 21 quality measures. Although the majority of the differences were not statistically significant, many of the quality measures showed slight improvements. These results continue to reflect a positive upward trend occurring in regards to member satisfaction with the behavioral health services for children. One measure showed a statistically significant difference between SFY 2008 and SFY 2010. The single-item measure “As far as you know did anyone your child saw for counseling or treatment share information with others that should have been kept private?” reflected a significant decrease in the percent of members who responded “yes” from 6.7% in SFY 2008 to 2.8% in SFY 2010. This may indicate that members perceive providers being more cautious about complying with HIPAA regulations regarding disclosure of personal health information. The SFY 2010 sampling methodology limited the sample pool to members who had a paid behavioral health claim. This method may have contributed to an increase in the adjusted response rate, which was 22.2% higher than the SFY 2008 rates. APS recommends the OHCA continue to follow this sampling methodology for future surveys. Appendix A ECHO® Child Survey Fiscal Year 2010 June 2010 Page 28 Appendix B Below are the responses by survey question. There were 633 total respondents with completed surveys. Frequencies in the tables reflect the number of people responding to each item; percentages in the tables reflect the number of respondents to the particular question. Q1 In the last 12 months, did your child get counseling, treatment or medicine for any of these reasons? Q1 Frequency Percent Yes 633 100.00 Q2 In the last 12 months, did you call someone to get professional counseling on the phone for your child? Q2 Frequency Percent Yes 222 35.86 No 397 64.14 Total 619 100.00 Q3 In the last 12 months, how often did you get the professional counseling your child needed on the phone? Q3 Frequency Percent Never 47 22.38 Sometimes 80 38.10 Usually 28 13.33 Always 55 26.19 Total 210 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 29 Q4 In the last 12 months, did your child need counseling or treatment right away? Q4 Frequency Percent Yes 254 40.25 No 377 59.75 Total 631 100.00 Q5 In the last 12 months, when your child needed counseling or treatment right away, how often did he or she see someone as soon as you wanted? Q5 Frequency Percent Never 20 7.97 Sometimes 33 13.15 Usually 70 27.89 Always 128 51.00 Total 251 100.00 Q6 In the last 12 months, not counting times your child needed counseling or treatment right away, did you make any appointments for your child for counseling or treatment? Q6 Frequency Percent Yes 510 81.21 No 118 18.79 Total 628 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 30 Q7 In the last 12 months, not counting times your child needed counseling or treatment right away, how often did your child get an appointment for counseling or treatment as soon as you wanted? Q7 Frequency Percent Never 13 2.59 Sometimes 70 13.94 Usually 147 29.28 Always 272 54.18 Total 502 100.00 Q8 In the last 12 months, how many times did your child go to an emergency room or crisis center to get counseling or treatment? Q8 Frequency Percent None 521 82.70 1 time 59 9.37 2 times 34 5.40 3 or more times 16 2.54 Total 630 100.00 Q9 In the last 12 months (not counting emergency rooms or crisis centers), how many times did your child get counseling, treatment or medicine in your home or at an office, clinic, or other treatment program? Q9 Frequency Percent None 0 0.00 1 to 10 times 278 43.92 11 to 20 times 171 27.01 21 or more times 184 29.07 Total 633 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 31 Q10 In the last 12 months, how many times did your child get counseling or treatment in your home? Q10 Frequency Percent None 478 75.87 1 to 10 times 74 11.75 11 to 20 times 37 5.87 21 or more times 41 6.51 Total 630 100.00 Q11 In the last 12 months, how often was your child seen within 15 minutes of his or her appointment? Q11 Frequency Percent Never 62 10.00 Sometimes 98 15.81 Usually 184 29.68 Always 276 44.52 Total 620 100.00 Q12 In the last 12 months, how often did the people your child saw for counseling or treatment listen carefully to you? Q12 Frequency Percent Never 17 2.71 Sometimes 56 8.93 Usually 140 22.33 Always 414 66.03 Total 627 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 32 Q13 In the last 12 months, how often did the people your child saw for counseling or treatment explain things in a way you could understand? Q13 Frequency Percent Never 14 2.23 Sometimes 40 6.36 Usually 143 22.73 Always 432 68.68 Total 629 100.00 Q14 In the last 12 months, how often did the people your child saw for counseling or treatment show respect for what you had to say? Q14 Frequency Percent Never 16 2.55 Sometimes 45 7.18 Usually 124 19.78 Always 442 70.49 Total 627 100.00 Q15 In the last 12 months, how often did the people your child saw for counseling or treatment spend enough time with you? Q15 Frequency Percent Never 24 3.83 Sometimes 79 12.62 Usually 151 24.12 Always 372 59.42 Total 626 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 33 Q16 In the last 12 months, did your child take any prescription medicines as part of his or her treatment? Q16 Frequency Percent Yes 457 72.42 No 174 27.58 Total 631 100.00 Q17 In the last 12 months, were you told what side effects of those medicines to watch for? Q17 Frequency Percent Yes 365 80.57 No 88 19.43 Total 453 100.00 Q18 In the last 12 months, how often were you involved as much as you wanted in your child’s counseling or treatment? Q18 Frequency Percent Never 18 2.86 Sometimes 53 8.43 Usually 102 16.22 Always 456 72.50 Total 629 100.00 Q19 In the last 12 months, were the goals of your child’s counseling or treatment discussed completely with you? Q19 Frequency Percent Yes 554 88.22 No 74 11.78 Total 628 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 34 Q20 In the last 12 months, how often did your family get the professional help you wanted for your child? Q20 Frequency Percent Never 32 5.16 Sometimes 63 10.16 Usually 151 24.35 Always 374 60.32 Total 620 100.00 Q21 In the last 12 months, how often did you feel your child had someone to talk to for counseling or treatment when he or she was troubled? Q21 Frequency Percent Never 36 5.83 Sometimes 80 12.97 Usually 154 24.96 Always 347 56.24 Total 617 100.00 Q22 In the last 12 months, were you given information about different kinds of counseling or treatment that are available for your child? Q22 Frequency Percent Yes 399 64.25 No 222 35.75 Total 621 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 35 Q23 In the last 12 months, were you given as much information as you wanted about what you could do to manage your child’s condition? Q23 Frequency Percent Yes 459 74.15 No 160 25.85 Total 619 100.00 Q24 In the last 12 months, were you given information about your child’s rights as a patient? Q24 Frequency Percent Yes 562 90.06 No 62 9.94 Total 624 100.00 Q25 In the last 12 months, did you feel you could refuse a specific type of medicine or treatment for your child? Q25 Frequency Percent Yes 541 87.68 No 76 12.32 Total 617 100.00 Q26 In the last 12 months, as far as you know did anyone your child saw for counseling or treatment share information with others that should have been kept private? Q26 Frequency Percent Yes 17 2.78 No 594 97.22 Total 611 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 36 Q27 Does your child’s language, race, religion, ethnic background or culture make any difference in the kind of counseling or treatment he or she needs? Q27 Frequency Percent Yes 40 6.53 No 573 93.47 Total 613 100.00 Q28 In the last 12 months, was the care your child received responsive to those needs? Q28 Frequency Percent Yes 30 76.92 No 9 23.08 Total 39 100.00 Q29 Using any number from 0 to 10, what number would you use to rate all your child’s counseling or treatment in the last 12 months? Q29 Frequency Percent 0 Worst 6 0.97 1 6 0.97 2 8 1.29 3 22 3.55 4 19 3.06 5 38 6.13 6 36 5.81 7 71 11.45 8 130 20.97 9 87 14.03 10 Best 197 31.77 Total 620 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 37 Q30 In the last 12 months, how much was your child helped by the counseling or treatment he or she got? Q30 Frequency Percent Not at all 32 5.14 A little 85 13.67 Somewhat 200 32.15 A lot 305 49.04 Total 622 100.00 Q31 In general, how would you rate your child’s overall mental health now? Q31 Frequency Percent Excellent 54 8.68 Very Good 133 21.38 Good 255 41.00 Fair 147 23.63 Poor 33 5.31 Total 622 100.00 Q32 Compared to 12 months ago, how would you rate your child’s ability to deal with daily problems now? Q32 Frequency Percent Much better 226 36.16 A little better 236 37.76 About the same 125 20.00 A little worse 22 3.52 Much worse 16 2.56 Total 625 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 38 Q33 Compared to 12 months ago, how would you rate your child’s ability to deal with social situations now? Q33 Frequency Percent Much better 192 30.77 A little better 233 37.34 About the same 156 25.00 A little worse 29 4.65 Much worse 14 2.24 Total 624 100.00 Q34 Compared to 12 months ago, how would you rate your child’s ability to accomplish the things he or she wants to do now? Q34 Frequency Percent Much better 207 33.33 A little better 236 38.00 About the same 151 24.32 A little worse 21 3.38 Much worse 6 0.97 Total 621 100.00 Q35 Compared to 12 months ago, how would you rate your child’s problems or symptoms now? Q35 Frequency Percent Much better 193 30.98 A little better 251 40.29 About the same 127 20.39 A little worse 41 6.58 Much worse 11 1.77 Total 623 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 39 Q36 Our records show that your child is now in SoonerCare Choice. Is that right? Q36 Frequency Percent Yes 618 99.36 No 4 0.64 Total 622 100.00 Q38 How many months or years in a row has your child been in this health plan? Q38 Frequency Percent Less than 1 year 22 3.62 1-2 years 48 7.91 2-5 years 155 25.54 5 or more years 382 62.93 Total 607 100.00 Q39 How much of the counseling or treatment your child got in the last 12 months was paid for by his or her health plan? Q39 Frequency Percent All of it 565 91.57 Most of it 26 4.21 Some of it 16 2.59 None of it 10 1.62 Total 617 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 40 Q40 Were you told about other ways to get counseling, treatment, or medicine for your child? Q40 Frequency Percent Yes 205 33.39 No 409 66.61 Total 614 100.00 Q41 When your child joined this health plan or at any time since then, did your child get someone new for counseling or treatment? Q41 Frequency Percent Yes 294 48.04 No 318 51.96 Total 612 100.00 Q42 Since your child joined this health plan, how much of a problem, if any, was it to get someone for your child you are happy with? Q42 Frequency Percent A big problem 44 15.22 A small problem 80 27.68 Not a problem 165 57.09 Total 289 100.00 Q43 In the last 12 months, did you need approval from your child’s health plan for any counseling or treatment? Q43 Frequency Percent Yes 238 39.21 No 369 60.79 Total 607 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 41 Q44 In the last 12 months, how much of a problem, if any, were delays in counseling or treatment while you waited for approval from your child’s health plan? Q44 Frequency Percent A big problem 24 10.30 A small problem 65 27.90 Not a problem 144 61.80 Total 233 100.00 Q45 In the last 12 months, how much of a problem, if any, was it to get the counseling or treatment you thought your child needed? Q45 Frequency Percent A big problem 48 7.87 A small problem 97 15.90 Not a problem 465 76.23 Total 610 100.00 Q46 In the last 12 months, did you look for any information about counseling or treatment from your child’s health plan in written materials or on the Internet? Q46 Frequency Percent Yes 192 31.22 No 423 68.78 Total 615 100.00 Q47 In the last 12 months, how much of a problem, if any, was it to find or understand this information? Q47 Frequency Percent A big problem 23 12.04 A small problem 55 28.80 Not a problem 113 59.16 Total 191 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 42 Q48 In the last 12 months, did you call the health plans customer service to get information or help about counseling or treatment for your child? Q48 Frequency Percent Yes 80 13.09 No 531 86.91 Total 611 100.00 Q49 In the last 12 months, how much of a problem, if any, was it to get the help you needed for your child when you called the health plans customer service? Q49 Frequency Percent A big problem 9 11.54 A small problem 22 28.21 Not a problem 47 60.26 Total 78 100.00 Q50 In the last 12 months, did you have to fill out any paperwork about counseling or treatment for your child’s health plan? Q50 Frequency Percent Yes 298 49.09 No 309 50.91 Total 607 100.00 Q51 In the last 12 months, how much of a problem, if any, did you have with paperwork for your child’s health plan? Q51 Frequency Percent A big problem 11 3.72 A small problem 44 14.86 Not a problem 241 81.42 Total 296 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 43 Q52 Using any number from 0 to 10, what number would you use to rate your child’s health plan for counseling or treatment? Q52 Frequency Percent 0 Worst 7 1.14 1 6 0.97 2 1 0.16 3 14 2.27 4 11 1.79 5 37 6.01 6 24 3.90 7 62 10.06 8 117 18.99 9 114 18.51 10 Best 223 36.20 Total 616 100.00 Q53 In the last 12 months, was any of your child’s counseling or treatment for problems related to ADHD or other behavior problems? Q53 Frequency Percent Yes 510 81.73 No 114 18.27 Total 624 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 44 Q54 In the last 12 months, was any of your child’s counseling or treatment for family problems or mental or emotional illness? Q54 Frequency Percent Yes 419 67.91 No 198 32.09 Total 617 100.00 Q55 In the last 12 months, was any of your child’s counseling or treatment for autism or other developmental problems? Q55 Frequency Percent Yes 136 22.30 No 474 77.70 Total 610 100.00 Q56 In the last 12 months, was any of your child’s counseling or treatment for help with alcohol use or drug use? Q56 Frequency Percent Yes 26 4.21 No 592 95.79 Total 618 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 45 Q57 In general, how would you rate your child’s overall health now? Q57 Frequency Percent Excellent 105 16.88 Very Good 213 34.24 Good 219 35.21 Fair 74 11.90 Poor 11 1.77 Total 622 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 46 Q58 What is your child’s age now? Q58 Frequency Percent 0 3 0.48 1 2 0.32 2 0 0.00 3 4 0.64 4 7 1.12 5 35 5.59 6 35 5.59 7 36 5.75 8 57 9.11 9 62 9.90 10 62 9.90 11 53 8.47 12 58 9.27 13 52 8.31 14 42 6.71 15 62 9.90 16 40 6.39 17 16 2.56 Total 626 100.00 Q59 Is your child male or female? Q59 Frequency Percent Male 387 62.22 Female 235 37.78 Total 622 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 47 * Respondents who selected more than one race were grouped in the multiracial / other category. Q60 Is your child of Hispanic or Latino origin or descent? Q60 Frequency Percent Yes, Hispanic or Latino 61 9.85 No, not Hispanic or Latino 558 90.15 Total 619 100.00 Q61 What is your child's race? Q61 Frequency Percent White 379 61.33 American Indian 64 10.36 Black or African American 63 10.19 Asian 1 0.16 Multiple or Other* 111 17.96 Total 618 100.00 Q62 What is your age now? Q62 Frequency Percent 18-24 10 1.62 25-34 226 36.69 35-44 206 33.44 45-54 108 17.53 55-64 42 6.82 65-74 22 3.57 75 or older 2 0.32 Total 616 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 48 Q63 Are you male or female? Q63 Frequency Percent Male 49 7.87 Female 574 92.13 Total 623 100.00 Q64 What is the highest grade or level of school that you have completed? Q64 Frequency Percent 8th grade or less 14 2.30 Some high school 79 12.97 HS grad or GED 229 37.60 Some college 233 38.26 College grad 37 6.08 More than 4yr college 17 2.79 Total 609 100.00 Q65 How are you related to the child? Q65 Frequency Percent Mother or Father 496 79.87 Grandparent 75 12.08 Aunt or Uncle 11 1.77 Other relative 4 0.64 Legal Guardian 35 5.64 Total 621 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 49 Q66 Did someone help you complete this survey? Q66 Frequency Percent Yes 15 2.94 No 496 97.06 Total 511 100.00 * Respondents could have selected more than one response. Respondents must have answered “Yes” to Q66 to respond on Q67. Q67 How did that person help you? (Mark all that apply) Frequency Read the questions to me 7 Wrote down the answers I gave 6 Answered the questions for me 3 Translated the questions into my language 1 Helped in some other way 5 Total * 15
Object Description
Description
Okla State Agency |
Health Care Authority, Oklahoma |
Title | ECHO child behavioral health survey for SoonerCare Choice 2010 |
OkDocs Class# | H1300.8 C536e 2010 |
Digital Format | PDF, Adobe Reader required |
ODL electronic copy | Downloaded from agency website: http://www.okhca.org/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=9366 |
Rights and Permissions | This Oklahoma state government publication is provided for educational purposes under U.S. copyright law. Other usage requires permission of copyright holders. |
Language | English |
Full text | Oklahoma Health Care Authority ECHO® Child Behavioral Health Survey for SoonerCare Choice Executive Summary and Technical Specifications Report for Contract: State Fiscal Year 2010 Data Reviewed: December 1, 2008 – November 30, 2009 Submitted: June 2010 Submitted by: APS Healthcare 4545 North Lincoln Boulevard Suite 24 Oklahoma City, Oklahoma 73105 (405) 556-9700 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 2 ECHO® Child Behavioral Health Survey for SoonerCare Choice Executive Summary The Oklahoma Health Care Authority (OHCA) is the state’s single agency responsible for administering Medicaid. The managed care component of this program is known as SoonerCare Choice, which operated under a partially capitated case management system during the first half of state fiscal year (SFY) 2009. A patient-centered medical home model was implemented January 1, 2009. In order to evaluate service satisfaction, the OHCA contracted with APS Healthcare (APS) to survey children enrolled in SoonerCare Choice who accessed outpatient behavioral health services between December 1, 2008, and November 30, 2009. This survey is conducted annually alternating between the adult and child populations. Comparing the 2008 survey and the 2010 survey, results indicated fairly high levels of satisfaction holding steady across an array of 21 quality measures. One measure showed a statistically significant difference between 2008 and 2010: • The composite measure “As far as you know did anyone your child saw for counseling or treatment share information with others that should have been kept private?” had a significant decrease of members who reported “yes” from 6.7% in 2008 to 2.8% in 2010. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 3 ECHO® Child Behavioral Health Survey for SoonerCare Choice Technical Specifications Consumer satisfaction surveys are an important source of information to consumers, purchasers of health care, health plans and program administrators. By responding to satisfaction surveys, individuals provide valuable information regarding access to care, use of services, and satisfaction with the care they have received. The practice of surveying the general population of managed care members about their overall experience with their health plan has extended to surveying special populations. This special population survey detailed responses of members enrolled in SoonerCare Choice who received outpatient behavioral health services through the SoonerCare program. The Oklahoma Health Care Authority (OHCA) is the state’s single agency responsible for administering Medicaid. The managed care component of this program is known as SoonerCare Choice, which operated under a partially capitated case management system during the first half of the state fiscal year (SFY) 2009. A patient-centered medical home model was implemented January 1, 2009. Behavioral health services are available to SoonerCare Choice members. In order to evaluate service satisfaction, the OHCA contracted with APS Healthcare to survey members enrolled in SoonerCare Choice who accessed outpatient behavioral health services between December 1, 2008, and November 30, 2009. This technical report includes information on the survey methodology, findings, and summary information on the respondents’ satisfaction with behavioral health services received. The OHCA annually administers the Experience of Care and Health Outcomes (ECHO) survey, version 3.0, to measure members’ satisfaction with behavior health services. The methodology for this survey was based on the Consumer Assessment of Healthcare Providers Systems (CAHPS®). The CAHPS surveys, administration protocol and survey analysis were developed by Harvard, RAND and the Research Triangle Institute. The ECHO survey was developed by behavioral health consumers, clinicians and behavioral health policy experts, including representatives from the National ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 4 Committee for Quality Assurance’s (NCQA) Behavioral Health Measurement Advisory Panel, the Center for Mental Health Services, and the National Alliance for the Mentally Ill. On alternating years the OHCA surveys adults about their experiences with behavioral health treatment and parents/guardians about their children’s behavioral health care. For SFY 2010 the survey focused on services provided to children; comparisons were made with results from SFY 2008, the last year during which SoonerCare Choice children were measured by the ECHO survey. Method The Child ECHO Health Plan survey 3.0 questionnaire (shown in Appendix A) was administered by The Myers Group (TMG) between December 1, 2009, and March 31, 2010. The survey covered several aspects of behavioral health services, including: • Access to care • Receiving care without long waits • Communication with clinicians • Family involvement in care • Perceived improvement in functioning • Patient’s rights • Experiences with the health plan The questionnaire also asked respondents to give overall ratings of the counseling or treatment they received and SoonerCare Choice. Sampling Because it was not feasible to survey the entire SoonerCare Choice population, recognized sampling techniques were used to obtain information from a limited number of members. This information was used to estimate the consumer satisfaction of the SoonerCare Choice population as a whole. Sampling and fielding of the survey was conducted by subcontract with a nationally certified CAHPS survey firm, TMG. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 5 Sampling for this survey followed CAHPS 3.0 protocols. APS provided TMG with a list of eligible members for sample selection. Each member included in the eligibility list met the following criteria: • 17 years of age or younger as of November 30, 2008; • Enrolled in the SoonerCare Choice program as of November 30, 2009 and • Continuously enrolled in SoonerCare Choice for 12 months between December 1, 2008, and November 30, 2009. (Continuous enrollment was defined as having no more than one 45-day break in enrollment during the year.) In addition, APS limited the pool of members to those who had paid claims for outpatient behavioral health services between December 1, 2008, and November 30, 2009, in hopes of improving response rates. In accordance with CAHPS recommendations and to reduce the burden on respondents, TMG randomly selected only one member from a household for the sample. The ECHO Survey and Reporting Kit 3.0 standards indicate that a minimum of 411 completed surveys were needed for a valid administration. Estimating a response rate of 40% and adjusting 15% for the underreporting of behavioral health services received, the recommended sample was 1,183 members. The total number of SoonerCare Choice members eligible for the survey was 17,202; TMG selected a random sample of 2,000 members. Data Collection The CAHPS survey methodology allowed data to be collected by mail, telephone interview, or a combination of mail and telephone. The OHCA and APS agreed to conduct the survey using mail, and incorporated telephone interviewing only when the targeted response rate was not received. The survey process had six outreach interventions that included mailings of the survey packet, reminder postcards, and phone follow-up with bilingual interviewers. After the sample was selected, address lists were processed using the U.S. Postal Service’s CASS Certified ZIP + 4 Coding Software, which verified the zip code for each address. Each packet included a questionnaire and a letter that explained the purpose and ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 6 the importance of the survey. To encourage participation, the packet also contained a postage-paid business reply envelope. Reminder postcards served to thank individuals who had responded to the survey and to remind others to complete their questionnaires. Members selected for the sample who did not respond to the first survey and/or postcard mailings were mailed a second survey. All correspondence included a toll-free number that members could use to contact TMG with questions regarding the survey or to complete the survey over the telephone. Each information letter contained a statement written in Spanish asking the member to call the toll-free number to take the survey by phone with a Spanish interpreter. If needed, follow-up calls were then initiated with bilingual interviewers. TMG developed a database to track the status of members selected for the sample at each stage of the survey protocol. The database identified members who had not returned the survey and needed subsequent mailings. The database also indicated the date that a member responded to the survey, refused to participate in the survey, or was determined to be ineligible for the survey. Members were determined to be ineligible for the survey if they no longer qualified for SoonerCare or had moved to a another state. The criteria for determining a complete ECHO survey was taken from Article X of the CAHPS Survey and Reporting Kit entitled, “Determining a Complete ECHO Questionnaire.” According to those criteria, if 9 of 18 key items were appropriately answered, the survey was considered complete. Only surveys that met these criteria were included in the analysis. Data Coding and Data Entry TMG recorded the responses to the questionnaires in a database specifically designed for this purpose. The data entry program permitted the entry of only those responses that were within the accepted range for each specific item; for example, if a rating was supposed to be on a scale of 0 to 10, a response of 12 could not be entered. APS performed a data clean-up process prior to the actual analysis to detect any additional out-of-range values and response inconsistencies. Typically, inconsistencies occurred when respondents did not follow the skip pattern of question groups. Whenever ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 7 feasible, APS recoded the items to conform to the questionnaire skip patterns; for example, if one response indicated the person did not receive forms to fill out, then any subsequent responses to questions about the ease of completing the forms were discarded. However, when the intent of the respondent could not be determined, the analyst recoded the item as missing. Data Analysis All analyses and calculations in the study were performed by APS using SAS Version 9.1. Frequencies were computed for all the items on the survey. Due to the lengthy results for this type of descriptive statistics, the frequency distributions are reported in Appendix B rather than in the results section. The main analysis compared this year’s survey results with those from the previous administration of the survey, which was in SFY 2008. This analysis produced three types of results: global ratings, composite measures, and individual items. Global ratings, which used a scale of 0 to 10, measured the respondents’ assessment of their health plan and the quality of the care received. APS computed the means for each global rating and used t-tests to compare means from the SFY 2008 and SFY 2010 SoonerCare Choice surveys. The two global ratings compared were: • Overall rating of treatment or counseling received by the child • Overall rating of the health plan. Composite measures combined the responses to questions that were closely related to each other and provided more comprehensive and meaningful results than comparing each item separately. APS computed the mean scores for each composite and used t-tests to compare means from the SFY 2008 and SFY 2010 SoonerCare Choice surveys. The five composite measures were compared were: • Experiences in getting treatment quickly • Experiences with how well clinicians communicate • Experiences in getting treatment and information from the plan • Perceived improvement from treatment ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 8 • Availability of professional help and support Individual items provided meaningful results concerning specific issues. For items with multiple responses, APS computed the mean scores for each individual item and used t-tests to compare results from the SFY 2008 and SFY 2010 SoonerCare Choice surveys. For items with dichotomous “yes/no” responses, APS computed chi-squared tests to compare results. The individual items that could be compared were: • Appointment waiting time • Amount child was helped by treatment • Informed about medication side effects • Discussed goals of treatment • Discussed treatment options • Informed about condition management • Informed about patient rights • Ability to refuse treatment options • Health information privacy • Responsiveness to cultural needs • Reasons for seeking treatment Results Table 1 shows the response by method for the current year’s survey and the previous administration of the survey in SFY 2008. Table 1. Completed Survey Response by Method and Year Completed Surveys SFY 2010 Survey SFY 2008 Survey Mailing 519 433 Phone Follow-Up 114 114 Total Completed Surveys 633 547 The study evaluated each returned questionnaire to determine if it met the CAHPS definition for a completed survey. To be considered complete, a questionnaire must have had appropriate responses to at least nine of 18 key questions identified by CAHPS. APS ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 9 coded returned questionnaires that did not pass the completion criteria as non-respondents and excluded them from the analysis. During SFY 2010, 380 surveys were deemed ineligible due to not meeting the criteria for completion. Table 2 shows the number of ineligible survey respondents by disposition. Table 2. Number of ineligible surveys for SFY 2010 Ineligible Disposition N % Did not meet criteria for completion 380 100% Total Ineligibles 380 100% The adjusted response rate, expressed as a percentage, is the number of completed surveys divided by the number of eligible surveys. Number of completed surveys Number of eligible surveys x 100 = Adjusted response rate (Total completed surveys) 633 (Sample) –(Ineligible) = 2000 – 380 x 100 = 39.1% The adjusted response rates for the current SoonerCare Choice survey was 39.1%; the adjusted response rates for the previous SoonerCare Choice survey was 32.0%. The difference in response rates probably is attributable to the decision in SFY 2010 to limit the sampling frame to participants who had a paid claim with a behavioral health provider during the sample timeframe. Demographics Respondents were asked their race and ethnicity. Figure 1 shows the results. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 10 Figure 1. ECHO Respondents’ Racial Identity Caucasian 61.3% American Indian 10.4% Multiracial / Other 18.0% Asian 0.2% African American 10.2% Results showed that the majority of participants (61.3%) were Caucasian. African Americans and American Indians were equally represented (10% each), and the remaining members reported another race or multiple races. In response to a separate question about ethnicity, 9.9% of respondents reported to be Hispanic or Latino. Global Ratings In Figures 2 and 3, the overall ratings are shown for the following: • Overall rating of treatment or counseling received • Overall rating of the health plan providing behavioral health services The means for the global rating items for the two years are shown in bar graphs. The table below each graph lists the number of respondents analyzed, the means, and the p-value associated with the statistical comparison between the two years, using a t-test. A p-value less than .05 was considered statistically significant. That is, if the p-value was less than .05, the two means were statistically different from each other; otherwise, the two means were not statistically different.* * APS used SAS PROC TTEST to compute the significance of difference between years. Reported p-values are from pooled tests with equal variances assumed: no items failed a test of equal variances. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 11 Overall Rating of Treatment or Counseling Received • Using any number from 0 to 10, where 0 is the worst counseling or treatment possible and 10 is the best counseling or treatment possible, what number would you use to rate all your child’s counseling or treatment in the last 12 months? Figure 2. Overall Rating of Treatment or Counseling Received 7.83 7.84 0 1 2 3 4 5 6 7 8 9 10 2008 2010 Mean Figure 2 demonstrates that SoonerCare Choice members remained fairly satisfied with the counseling and treatment received in 2010 compared with the ratings in 2008. The slight increase was not statistically significant. Year N Mean p-value 2010 620 7.84 2008 287 7.83 .9371 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 12 Overall Rating for Health Plan on Providing Behavioral Health Services • Using any number from 0 to 10, where 0 is the worst health plan possible and 10 is the best health plan possible, what number would you use to rate your child’s health plan for counseling or treatment? Figure 3. Overall Rating for Health Plan on Providing Behavioral Health Services 8.19 8.20 0 1 2 3 4 5 6 7 8 9 10 2008 2010 Mean Year N Mean p-value 2010 616 8.20 2008 349 8.19 .9910 Figure 3 shows that SoonerCare Choice members were satisfied with the provision of behavioral health services in 2010. The slight increase from 2008 was not statistically significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 13 Composite Measures In Figures 4 through 8, the following composite measures are provided: • Experiences in getting treatment quickly • Experiences with how well clinicians communicate • Experiences in getting treatment and information from the plan • Perceived improvement from treatment • Availability of help and support The percentage in each category for the composite measures is shown in the bar graph. The table below each graph lists the number of respondents analyzed, and the mean and the p-value associated with the statistical comparison between the two years. The smallest categories are combined for display purposes only, so that percentages can be shown for each category in the graph. See footnotes below each table on how recoding was performed. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 14 Getting Treatment Quickly • In the last 12 months, how often did you get the professional counseling your child needed on the phone? • In the last 12 months, when your child needed counseling or treatment right away, how often did he or she see someone as soon as you wanted? • In the last 12 months, not counting times your child needed counseling or treatment right away, how often did your child get an appointment for counseling or treatment as soon as you wanted? Figure 4. Getting Treatment Quickly 31.50% 32.71% 24.64% 23.50% 43.86% 43.79% 0% 20% 40% 60% 80% 100% 2008 2010 Never/Sometimes Usually Always Year N Mean* p-value 2010 549 3.00 2008 294 3.01 .3195 * Responses of “Never” and “Sometimes” were recoded to 1, responses of “Usually” were recoded to 2 and responses of “Always” were recoded to 3. Figure 4 shows that 67.3% of the respondents in 2010 reported usually or always receiving treatment quickly. This was a decrease from 2008 when 68.5% of respondents reported usually or always receiving treatment quickly. The mean difference was not statistically significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 15 How Well Clinicians Communicate • In the last 12 months, how often did the people your child saw for counseling or treatment listen carefully to you? • In the last 12 months, how often did the people your child saw for counseling or treatment explain things in a way you could understand? • In the last 12 months, how often did the people your child saw for counseling or treatment show respect for what you had to say? • In the last 12 months, how often did the people your child saw for counseling or treatment spend enough time with you? • In the last 12 months, how often were you involved as much as you wanted in your child’s counseling or treatment? Figure 5. How Well Clinicians Communicate 11.63% 19.56% 68.81% 11.54% 21.04% 67.42% 0% 20% 40% 60% 80% 100% 2008 2010 Never/Sometimes Usually Always Year N Mean* p-value 2010 633 3.53 2008 290 3.55 .8788 * Responses of “Never” and “Sometimes” were recoded to 1, responses of “Usually” were recoded to 2 and responses of “Always” were recoded to 3. Figure 5 shows that 88% of members felt that clinicians usually or always communicated well during 2010, the same as 2008. The mean difference was not significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 16 Access to Treatment and Information from the Health Plan • Since your child joined this health plan, how much of a problem, if any, was it to get someone for your child you are happy with? • In the last 12 months, how much of a problem, if any, were delays in counseling or treatment while you waited for approval from your child’s health plan? • In the last 12 months, how much of a problem, if any, was it to get the counseling or treatment you thought your child needed? • In the last 12 months, how much of a problem, if any, was it to find or understand information (about counseling or treatment)? • In the last 12 months, how much of a problem, if any, was it to get the help you needed for your child when you called the health plan’s customer service? • In the last 12 months, how much of a problem, if any, did you have with paperwork for your child’s health plan? Figure 6. Access to Treatment and Information from the Health Plan 24.25% 23.89% 66.56% 65.99% 9.18% 10.12% 0% 20% 40% 60% 80% 100% 2008 2010 Big Problem Small Problem Not a Problem Year N Mean p-value 2010 618 2.56 2008 351 2.57 .6891 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 17 Figure 6 demonstrates that 89.9% of respondents indicated no problem with access to treatment and information in 2010, compared with 90.8% in 2008. The mean difference in average ratings was not statistically significant. Perceived Improvement from Treatment • Compared to 12 months ago, how would you rate your child’s ability to deal with daily problems now? • Compared to 12 months ago, how would you rate your child’s ability to deal with social situations now? • Compared to 12 months ago, how would you rate your child’s ability to accomplish the things he or she wants to do now? • Compared to 12 months ago, how would you rate your child’s problems or symptoms now? Figure 7. Perceived Improvement from Treatment 31.63% 32.81% 42.66% 38.35% 20.42% 22.43% 5.3% 6.4% 0% 20% 40% 60% 80% 100% 2008 2010 Much Better A Little Better About the Same A Little/Much Worse Year N Mean* p-value 2010 627 2.04 2008 359 2.01 .6213 * Responses of “Much better” were recoded to 1, responses of “A little better” were recoded to 2, responses of “About the same” were recoded to 3, responses of “A little worse” and “Much worse” were recoded to 4. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 18 Figure 7 shows that 71.2% of respondents in 2010 believed their child was “much better” or “a little better”, compared with 74.3% in 2008. The mean difference was not statistically significant. Availability of Help and Support • In the last 12 months, how often did your family get the professional help you wanted for your child? • In the last 12 months, how often did you feel your child had someone to talk to for counseling or treatment when he or she was troubled? Figure 8. Availability of Help and Support 19.41% 17.06% 26.05% 24.66% 54.55% 58.28% 0% 20% 40% 60% 80% 100% 2008 2010 Never/Sometimes Usually Always Year N Mean* p-value 2010 627 3.36 2008 288 3.31 .4424 * Responses of “Never” and “Sometimes” were recoded to 1, responses of “Usually” were recoded to 2 and responses of “Always” were recoded to 3. Figure 8 shows that 82.9% of respondents in 2010 believed their child “usually” or “always” had professional help and support available, compared with 80.6% in 2008. The difference of means was not statistically significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 19 Single Item Measures Figures 9 and 10, and Table 2 compare results for the following single item measures: • Appointment waiting time • Amount child was helped by treatment • Informed about medication side effects • Discussed goals of treatment • Discussed treatment options • Informed about condition management • Informed about patient rights • Ability to refuse treatment options • Health information privacy • Responsiveness to cultural needs • Reasons for seeking treatment Table 2 contains the percentage who answered “yes” to yes/no questions in 2008 and 2010, as well as the p-value for a statistical chi-squared test of the difference between years. Differences with p-values of .05 or less are considered statistically significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 20 Appointment Waiting Time • In the last 12 months, how often was your child seen within 15 minutes of his or her appointment? Figure 9. Appointment Waiting Time 23.71% 25.81% 33.33% 29.68% 42.96% 44.52% 0% 20% 40% 60% 80% 100% 2008 2010 Never/Sometimes Usually Always Year N Mean* p-value 2010 620 3.09 2008 291 3.10 .8197 * Responses of “Never” and “Sometimes” were recoded to 1, responses of “Usually” were recoded to 2 and responses of “Always” were recoded to 3. Figure 9 shows that 74.2% of respondents in 2010 said their child “usually” or “always” was seen within 15 minutes, compared with 76.3% in 2008. The difference of means was not statistically significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 21 How Much Your Child was Helped • In the last 12 months, how much was your child helped by the counseling or treatment he or she got? Figure 10. How Much Child was Helped 20.96% 18.81% 28.90% 32.15% 50.14% 49.04% 0% 20% 40% 60% 80% 100% 2008 2010 Not at all/A little Somewhat A lot Year N Mean* p-value 2010 622 3.25 2008 353 3.23 .6856 * Responses of “Not at all” and “A little” were recoded to 1, responses of “Somewhat” were recoded to 2 and responses of “A lot” were recoded to 3. Figure 10 shows that 81.2% of respondents in 2010 said their child was helped “somewhat” or “a lot”, compared with 79.0% in 2008. The difference of means was not statistically significant. ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 22 Table 3. Percent Responding “Yes” to Single-Item Measures Item SFY 2008 SFY 2010 p-value Were you told what side effects of those medicines to watch for? 80.30% 80.57% .9337 Were the goals of your child’s counseling or treatment discussed completely with you? 89.55% 88.22% .5563 Were you given information about different kinds of counseling or treatment that are available for your child? 62.11% 64.25% .5331 Were you given as much information as you wanted about what you could do to manage your child’s condition? 73.17% 74.15% .7546 Were you given information about your child’s rights as a patient? 88.61% 90.06% .5077 Did you feel you could refuse a specific type of medicine or treatment for your child? 87.06% 87.68% .7936 As far as you know did anyone your child saw for counseling or treatment share information with others that should have been kept private? 6.67% 2.78% .0058* Was the care your child received responsive to those (cultural) needs? 75.00% 76.92% .8908 Was any of your child’s counseling or treatment for problems related to ADHD or other behavior problems? 77.90% 81.73% .1481 Was any of your child’s counseling or treatment for family problems or mental or emotional illness? 66.76% 67.91% .7146 Was any of your child’s counseling or treatment for autism or other developmental problems? 20.00% 22.30% .4044 Was any of your child’s counseling or treatment for help with alcohol use or drug use? 5.16% 4.21% .4958 * Statistically significant ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 23 Discussion Comparing the SFY 2008 survey and the SFY 2010 survey, results indicated relatively high levels of satisfaction holding steady across an array of 21 quality measures. Although the majority of the differences were not statistically significant, many of the quality measures showed slight improvements. These results continue to reflect a positive upward trend occurring in regards to member satisfaction with the behavioral health services for children. One measure showed a statistically significant difference between SFY 2008 and SFY 2010. The single-item measure “As far as you know did anyone your child saw for counseling or treatment share information with others that should have been kept private?” reflected a significant decrease in the percent of members who responded “yes” from 6.7% in SFY 2008 to 2.8% in SFY 2010. This may indicate that members perceive providers being more cautious about complying with HIPAA regulations regarding disclosure of personal health information. The SFY 2010 sampling methodology limited the sample pool to members who had a paid behavioral health claim. This method may have contributed to an increase in the adjusted response rate, which was 22.2% higher than the SFY 2008 rates. APS recommends the OHCA continue to follow this sampling methodology for future surveys. Appendix A ECHO® Child Survey Fiscal Year 2010 June 2010 Page 28 Appendix B Below are the responses by survey question. There were 633 total respondents with completed surveys. Frequencies in the tables reflect the number of people responding to each item; percentages in the tables reflect the number of respondents to the particular question. Q1 In the last 12 months, did your child get counseling, treatment or medicine for any of these reasons? Q1 Frequency Percent Yes 633 100.00 Q2 In the last 12 months, did you call someone to get professional counseling on the phone for your child? Q2 Frequency Percent Yes 222 35.86 No 397 64.14 Total 619 100.00 Q3 In the last 12 months, how often did you get the professional counseling your child needed on the phone? Q3 Frequency Percent Never 47 22.38 Sometimes 80 38.10 Usually 28 13.33 Always 55 26.19 Total 210 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 29 Q4 In the last 12 months, did your child need counseling or treatment right away? Q4 Frequency Percent Yes 254 40.25 No 377 59.75 Total 631 100.00 Q5 In the last 12 months, when your child needed counseling or treatment right away, how often did he or she see someone as soon as you wanted? Q5 Frequency Percent Never 20 7.97 Sometimes 33 13.15 Usually 70 27.89 Always 128 51.00 Total 251 100.00 Q6 In the last 12 months, not counting times your child needed counseling or treatment right away, did you make any appointments for your child for counseling or treatment? Q6 Frequency Percent Yes 510 81.21 No 118 18.79 Total 628 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 30 Q7 In the last 12 months, not counting times your child needed counseling or treatment right away, how often did your child get an appointment for counseling or treatment as soon as you wanted? Q7 Frequency Percent Never 13 2.59 Sometimes 70 13.94 Usually 147 29.28 Always 272 54.18 Total 502 100.00 Q8 In the last 12 months, how many times did your child go to an emergency room or crisis center to get counseling or treatment? Q8 Frequency Percent None 521 82.70 1 time 59 9.37 2 times 34 5.40 3 or more times 16 2.54 Total 630 100.00 Q9 In the last 12 months (not counting emergency rooms or crisis centers), how many times did your child get counseling, treatment or medicine in your home or at an office, clinic, or other treatment program? Q9 Frequency Percent None 0 0.00 1 to 10 times 278 43.92 11 to 20 times 171 27.01 21 or more times 184 29.07 Total 633 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 31 Q10 In the last 12 months, how many times did your child get counseling or treatment in your home? Q10 Frequency Percent None 478 75.87 1 to 10 times 74 11.75 11 to 20 times 37 5.87 21 or more times 41 6.51 Total 630 100.00 Q11 In the last 12 months, how often was your child seen within 15 minutes of his or her appointment? Q11 Frequency Percent Never 62 10.00 Sometimes 98 15.81 Usually 184 29.68 Always 276 44.52 Total 620 100.00 Q12 In the last 12 months, how often did the people your child saw for counseling or treatment listen carefully to you? Q12 Frequency Percent Never 17 2.71 Sometimes 56 8.93 Usually 140 22.33 Always 414 66.03 Total 627 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 32 Q13 In the last 12 months, how often did the people your child saw for counseling or treatment explain things in a way you could understand? Q13 Frequency Percent Never 14 2.23 Sometimes 40 6.36 Usually 143 22.73 Always 432 68.68 Total 629 100.00 Q14 In the last 12 months, how often did the people your child saw for counseling or treatment show respect for what you had to say? Q14 Frequency Percent Never 16 2.55 Sometimes 45 7.18 Usually 124 19.78 Always 442 70.49 Total 627 100.00 Q15 In the last 12 months, how often did the people your child saw for counseling or treatment spend enough time with you? Q15 Frequency Percent Never 24 3.83 Sometimes 79 12.62 Usually 151 24.12 Always 372 59.42 Total 626 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 33 Q16 In the last 12 months, did your child take any prescription medicines as part of his or her treatment? Q16 Frequency Percent Yes 457 72.42 No 174 27.58 Total 631 100.00 Q17 In the last 12 months, were you told what side effects of those medicines to watch for? Q17 Frequency Percent Yes 365 80.57 No 88 19.43 Total 453 100.00 Q18 In the last 12 months, how often were you involved as much as you wanted in your child’s counseling or treatment? Q18 Frequency Percent Never 18 2.86 Sometimes 53 8.43 Usually 102 16.22 Always 456 72.50 Total 629 100.00 Q19 In the last 12 months, were the goals of your child’s counseling or treatment discussed completely with you? Q19 Frequency Percent Yes 554 88.22 No 74 11.78 Total 628 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 34 Q20 In the last 12 months, how often did your family get the professional help you wanted for your child? Q20 Frequency Percent Never 32 5.16 Sometimes 63 10.16 Usually 151 24.35 Always 374 60.32 Total 620 100.00 Q21 In the last 12 months, how often did you feel your child had someone to talk to for counseling or treatment when he or she was troubled? Q21 Frequency Percent Never 36 5.83 Sometimes 80 12.97 Usually 154 24.96 Always 347 56.24 Total 617 100.00 Q22 In the last 12 months, were you given information about different kinds of counseling or treatment that are available for your child? Q22 Frequency Percent Yes 399 64.25 No 222 35.75 Total 621 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 35 Q23 In the last 12 months, were you given as much information as you wanted about what you could do to manage your child’s condition? Q23 Frequency Percent Yes 459 74.15 No 160 25.85 Total 619 100.00 Q24 In the last 12 months, were you given information about your child’s rights as a patient? Q24 Frequency Percent Yes 562 90.06 No 62 9.94 Total 624 100.00 Q25 In the last 12 months, did you feel you could refuse a specific type of medicine or treatment for your child? Q25 Frequency Percent Yes 541 87.68 No 76 12.32 Total 617 100.00 Q26 In the last 12 months, as far as you know did anyone your child saw for counseling or treatment share information with others that should have been kept private? Q26 Frequency Percent Yes 17 2.78 No 594 97.22 Total 611 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 36 Q27 Does your child’s language, race, religion, ethnic background or culture make any difference in the kind of counseling or treatment he or she needs? Q27 Frequency Percent Yes 40 6.53 No 573 93.47 Total 613 100.00 Q28 In the last 12 months, was the care your child received responsive to those needs? Q28 Frequency Percent Yes 30 76.92 No 9 23.08 Total 39 100.00 Q29 Using any number from 0 to 10, what number would you use to rate all your child’s counseling or treatment in the last 12 months? Q29 Frequency Percent 0 Worst 6 0.97 1 6 0.97 2 8 1.29 3 22 3.55 4 19 3.06 5 38 6.13 6 36 5.81 7 71 11.45 8 130 20.97 9 87 14.03 10 Best 197 31.77 Total 620 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 37 Q30 In the last 12 months, how much was your child helped by the counseling or treatment he or she got? Q30 Frequency Percent Not at all 32 5.14 A little 85 13.67 Somewhat 200 32.15 A lot 305 49.04 Total 622 100.00 Q31 In general, how would you rate your child’s overall mental health now? Q31 Frequency Percent Excellent 54 8.68 Very Good 133 21.38 Good 255 41.00 Fair 147 23.63 Poor 33 5.31 Total 622 100.00 Q32 Compared to 12 months ago, how would you rate your child’s ability to deal with daily problems now? Q32 Frequency Percent Much better 226 36.16 A little better 236 37.76 About the same 125 20.00 A little worse 22 3.52 Much worse 16 2.56 Total 625 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 38 Q33 Compared to 12 months ago, how would you rate your child’s ability to deal with social situations now? Q33 Frequency Percent Much better 192 30.77 A little better 233 37.34 About the same 156 25.00 A little worse 29 4.65 Much worse 14 2.24 Total 624 100.00 Q34 Compared to 12 months ago, how would you rate your child’s ability to accomplish the things he or she wants to do now? Q34 Frequency Percent Much better 207 33.33 A little better 236 38.00 About the same 151 24.32 A little worse 21 3.38 Much worse 6 0.97 Total 621 100.00 Q35 Compared to 12 months ago, how would you rate your child’s problems or symptoms now? Q35 Frequency Percent Much better 193 30.98 A little better 251 40.29 About the same 127 20.39 A little worse 41 6.58 Much worse 11 1.77 Total 623 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 39 Q36 Our records show that your child is now in SoonerCare Choice. Is that right? Q36 Frequency Percent Yes 618 99.36 No 4 0.64 Total 622 100.00 Q38 How many months or years in a row has your child been in this health plan? Q38 Frequency Percent Less than 1 year 22 3.62 1-2 years 48 7.91 2-5 years 155 25.54 5 or more years 382 62.93 Total 607 100.00 Q39 How much of the counseling or treatment your child got in the last 12 months was paid for by his or her health plan? Q39 Frequency Percent All of it 565 91.57 Most of it 26 4.21 Some of it 16 2.59 None of it 10 1.62 Total 617 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 40 Q40 Were you told about other ways to get counseling, treatment, or medicine for your child? Q40 Frequency Percent Yes 205 33.39 No 409 66.61 Total 614 100.00 Q41 When your child joined this health plan or at any time since then, did your child get someone new for counseling or treatment? Q41 Frequency Percent Yes 294 48.04 No 318 51.96 Total 612 100.00 Q42 Since your child joined this health plan, how much of a problem, if any, was it to get someone for your child you are happy with? Q42 Frequency Percent A big problem 44 15.22 A small problem 80 27.68 Not a problem 165 57.09 Total 289 100.00 Q43 In the last 12 months, did you need approval from your child’s health plan for any counseling or treatment? Q43 Frequency Percent Yes 238 39.21 No 369 60.79 Total 607 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 41 Q44 In the last 12 months, how much of a problem, if any, were delays in counseling or treatment while you waited for approval from your child’s health plan? Q44 Frequency Percent A big problem 24 10.30 A small problem 65 27.90 Not a problem 144 61.80 Total 233 100.00 Q45 In the last 12 months, how much of a problem, if any, was it to get the counseling or treatment you thought your child needed? Q45 Frequency Percent A big problem 48 7.87 A small problem 97 15.90 Not a problem 465 76.23 Total 610 100.00 Q46 In the last 12 months, did you look for any information about counseling or treatment from your child’s health plan in written materials or on the Internet? Q46 Frequency Percent Yes 192 31.22 No 423 68.78 Total 615 100.00 Q47 In the last 12 months, how much of a problem, if any, was it to find or understand this information? Q47 Frequency Percent A big problem 23 12.04 A small problem 55 28.80 Not a problem 113 59.16 Total 191 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 42 Q48 In the last 12 months, did you call the health plans customer service to get information or help about counseling or treatment for your child? Q48 Frequency Percent Yes 80 13.09 No 531 86.91 Total 611 100.00 Q49 In the last 12 months, how much of a problem, if any, was it to get the help you needed for your child when you called the health plans customer service? Q49 Frequency Percent A big problem 9 11.54 A small problem 22 28.21 Not a problem 47 60.26 Total 78 100.00 Q50 In the last 12 months, did you have to fill out any paperwork about counseling or treatment for your child’s health plan? Q50 Frequency Percent Yes 298 49.09 No 309 50.91 Total 607 100.00 Q51 In the last 12 months, how much of a problem, if any, did you have with paperwork for your child’s health plan? Q51 Frequency Percent A big problem 11 3.72 A small problem 44 14.86 Not a problem 241 81.42 Total 296 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 43 Q52 Using any number from 0 to 10, what number would you use to rate your child’s health plan for counseling or treatment? Q52 Frequency Percent 0 Worst 7 1.14 1 6 0.97 2 1 0.16 3 14 2.27 4 11 1.79 5 37 6.01 6 24 3.90 7 62 10.06 8 117 18.99 9 114 18.51 10 Best 223 36.20 Total 616 100.00 Q53 In the last 12 months, was any of your child’s counseling or treatment for problems related to ADHD or other behavior problems? Q53 Frequency Percent Yes 510 81.73 No 114 18.27 Total 624 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 44 Q54 In the last 12 months, was any of your child’s counseling or treatment for family problems or mental or emotional illness? Q54 Frequency Percent Yes 419 67.91 No 198 32.09 Total 617 100.00 Q55 In the last 12 months, was any of your child’s counseling or treatment for autism or other developmental problems? Q55 Frequency Percent Yes 136 22.30 No 474 77.70 Total 610 100.00 Q56 In the last 12 months, was any of your child’s counseling or treatment for help with alcohol use or drug use? Q56 Frequency Percent Yes 26 4.21 No 592 95.79 Total 618 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 45 Q57 In general, how would you rate your child’s overall health now? Q57 Frequency Percent Excellent 105 16.88 Very Good 213 34.24 Good 219 35.21 Fair 74 11.90 Poor 11 1.77 Total 622 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 46 Q58 What is your child’s age now? Q58 Frequency Percent 0 3 0.48 1 2 0.32 2 0 0.00 3 4 0.64 4 7 1.12 5 35 5.59 6 35 5.59 7 36 5.75 8 57 9.11 9 62 9.90 10 62 9.90 11 53 8.47 12 58 9.27 13 52 8.31 14 42 6.71 15 62 9.90 16 40 6.39 17 16 2.56 Total 626 100.00 Q59 Is your child male or female? Q59 Frequency Percent Male 387 62.22 Female 235 37.78 Total 622 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 47 * Respondents who selected more than one race were grouped in the multiracial / other category. Q60 Is your child of Hispanic or Latino origin or descent? Q60 Frequency Percent Yes, Hispanic or Latino 61 9.85 No, not Hispanic or Latino 558 90.15 Total 619 100.00 Q61 What is your child's race? Q61 Frequency Percent White 379 61.33 American Indian 64 10.36 Black or African American 63 10.19 Asian 1 0.16 Multiple or Other* 111 17.96 Total 618 100.00 Q62 What is your age now? Q62 Frequency Percent 18-24 10 1.62 25-34 226 36.69 35-44 206 33.44 45-54 108 17.53 55-64 42 6.82 65-74 22 3.57 75 or older 2 0.32 Total 616 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 48 Q63 Are you male or female? Q63 Frequency Percent Male 49 7.87 Female 574 92.13 Total 623 100.00 Q64 What is the highest grade or level of school that you have completed? Q64 Frequency Percent 8th grade or less 14 2.30 Some high school 79 12.97 HS grad or GED 229 37.60 Some college 233 38.26 College grad 37 6.08 More than 4yr college 17 2.79 Total 609 100.00 Q65 How are you related to the child? Q65 Frequency Percent Mother or Father 496 79.87 Grandparent 75 12.08 Aunt or Uncle 11 1.77 Other relative 4 0.64 Legal Guardian 35 5.64 Total 621 100.00 ECHO® Child SoonerCare Choice Survey Fiscal Year 2010 June 2010 Page 49 Q66 Did someone help you complete this survey? Q66 Frequency Percent Yes 15 2.94 No 496 97.06 Total 511 100.00 * Respondents could have selected more than one response. Respondents must have answered “Yes” to Q66 to respond on Q67. Q67 How did that person help you? (Mark all that apply) Frequency Read the questions to me 7 Wrote down the answers I gave 6 Answered the questions for me 3 Translated the questions into my language 1 Helped in some other way 5 Total * 15 |
Date created | 2011-11-29 |
Date modified | 2011-11-29 |
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