Saginaw MAX System of Care Year to Date Enrollment Summary

June 18, 2013

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The following information was compiled from National Outcome Measures (NOMs) interviews completed with youth or their caregivers by Care Coordinators and the Family Guide when youth and families enter services.

Summary of Youth Enrolled in Saginaw MAX System of Care

Through June 18, 2013, 100 youth* have been enrolled into Saginaw MAX System of Care services since the beginning of project services in October 2011. Through June 18, 2013, the majority of youth 69% were enrolled into Wraparound. The remaining 31% were enrolled in other SOC services. Average age of youth is 11.7 years** 67% are male** 39% identify as Black or African American**
* This represents an unduplicated count. ** 97 youth had NOMs demographic information available at the time this report was created.

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Of the 100 enrolled youth with NOMs demographic information available through June 18, 2013
What is their gender*? Male Female 67% 33%

What is your gender?

FEMALE, 33%

MALE FEMALE

MALE, 67%

*Totals may not add to 100% because of rounding.

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What are their ages*?

6 years 7 years 8 years 9 years 10 years 11 years 4% 8% 12% 4% 6% 6% (4) (8) (12) (4) (6) (6) 12 years 13 years 14 years 15 years 16 years 17 years 13% 11% 13% 9% 7% 4% (13) (11) (13) (9) (7) (4)

*Totals may not add to 100% because of rounding.

Calculated Age at Baseline

17 (4%) 6 (4%)

16 (7%)

7 (8%) 6 7 8 (12%) 8 9 10 11 12 13 14 10 (6%) 15 16 17

15 (9%)

14 (13%)

9 (4%)

13 (11%) 12 (13%)

11 (6%)

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Of the 100 enrolled youth with NOMs demographic information available through June 18, 2013
What is their race/ethnicity*? (n = 95) Black or African American White Multi-racial Asian Native Hawaiian or Pacific Islander Alaska Native American Indian None of the above
*Totals may not add to 100% because of rounding.

39% 31% 22% 0% 0% 1% 0% 7%

What race do you consider yourself [your child]?

None of the above, 7% Black or African American, 39% Black or African American Alaska Native White Multi-Racial None of the above

Multi-Racial, 22%

Alaska Native, 1% White, 31%

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Are the youth Hispanic or Latino? (n = 97)

Hispanic or Latino Not Hispanic or Latino 14% 86%

Hispanic or Latino
Yes 14%

No Yes

No 86%

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Where were youth living for most of the time in the 30 days prior to their NOMs interview?
(n = 96) Owned or rented house, apartment, trailer, room Foster care Correctional facility Someone elses house, apartment, trailer, room Hospital (psychiatric) Other housed 66% 23% 7% 2% 1% 1%

In the past 30 days, where have you [your child] been living most of the time?
1% 7% 1% Owned or rented house, apartment, trailer, room Someone else's house, apartment, trailer, room Foster care Hospital (psychiatric) Correctional facility 2% 66% Other housed (specify)

23%

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The following information was compiled from the Enrollment and Demographic Information Form (EDIF) completed when youth and families enter services. The EDIF gathers demographic, diagnostic, and system of care enrollment information on all children receiving system of care services. Information for the EDIF is gathered from record review. Referral Agency

Referral Agency[a]

Corrections Juvenile Court Probation School Mental Health Physical Health Public Child Welfare Tribal Child Welfare Substance Abuse Clinic Family Court Caregiver Self Early Head Start Head Start Early Intervention (Part C) Preschl Spec Ed (Part B) Early Care: Other Other
0%

2% 6% 16% 2% 5% 0% 38% 0% 0% 3% 20% 1% 0% 0% 0% 0% 0% 6%

20% 40% 60% 80% 100%

n = 95
[a] Mental health = Mental health agency, clinic or provider; Physical health = Physical health care agency, clinic, or provider.

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Agency Involvement

Agency Involvement[a,b,c]
Corrections Juvenile Court Probation School Mental Health Physical Health Public Child Welfare Substance Abuse Clinic Family Court Early Head Start Head Start Early Intervention (Part C) Preschl Spec Ed (Part B) Early Care: Other Other
0%

0% 13% 28% 40% 97%

13% 46% 0% 10% 0% 0% 0% 0% 0% 1%

20% 40% 60% 80% 100%

n = 95
[a] Data reported were collected using the Enrollment and Demographic Information Form (EDIF). [b] Mental health = Mental health agency, clinic or provider; Physical health = Physical health care agency, clinic, or provider. [c] Because individuals may report involvement in more than one agency, percentages may sum to more than 100%.

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Top 5 Axis I and Axis II Diagnoses [a,b]:

(n=91)

Attention Deficit Hyperactivity Disorder 56%

Mood Disorders

Oppositional Defiant Disorder 51%

PTSD and Acute Stress Disorders 33%

Impulse Control Disorders 9%

51%

[a] Data reported were collected using the Enrollment and Demographic Information Form (EDIF). [b] Because children and youth may have more than one diagnosis, percentages for diagnoses may sum to more than 100%.

What social and environmental problems are youth most commonly experiencing at intake?*
100%
87% 89% 80%

80%

60%

56%

40%
25%

20%
0% 4%

13% 4%

0%

Primary Social Educational Occupational Support** Environment*** Housing

Economic

Access to Healthcare

Legal

Other****

(n=84) * Because youth may experience more than one psychosocial or environmental problem, problems may add to more than 100%. ** Primary support problems include health problems in family, removal from the home, remarriage or divorce of parent, and child abuse or neglect. *** Social environment problems include inadequate social support, death or loss of a friend, and adjustments to life cycle transitions. **** Other problems include discord with non-family caregivers, unavailability of social service agencies, and exposure to disasters.

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Presenting Problems Reported

How do youth self-reported problems compare with the presenting problems recorded in their charts1?
1

Baseline interviews are conducted by the evaluation team within 30 days of the youth and family enrolling into Wraparound. Record review refers to problems listed in the Enrollment and Demographic Information Form completed at enrollment into services.

Suicidal Ideation/Self-Injury Depression Anxiety Hyperactivity and Attention

Presenting Problems *

5% 20% 15%

26% 27% 28% 25% 15% 14% 10% 40% 66%

Conduct/Delinquency Substance Use Adjustment Psychotic Behaviors 0% 0% 3% 0% 1% 0% 0% 0% 2% 0% 0%

18% 10%
Record Review Youth Self-Report

Pervasive Developmental Disability Specific Developmental Disability Learning Disability School Performance Eating Disorder Other

20% 59%

30%

0%
Record Review: n = 95 Youth Self-Report: n = 20

20%

40%

60%

80%

100%

* Because youth may present with more than one problem, percentages for presenting problems sum to more than 100%.

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School Attendance in the 6 Months Prior to Intake for Saginaw MAX services
Caregiver reports [a] indicated that children (100%) attended school in the six months prior to intake. (n = 28)

[a] Data reported were collected using the Education Questionnaire QuestionnaireRevision 2 (EQR2). This instrument collects data on the status of the child/family in the 6 months prior to the interview.

As part of the baseline evaluation interview, caregivers were asked about youths attendance at school*:
Perfect Attendance Less than 1 day per month About 1 day per month About 1 day every 2 weeks About 1 day per week 2 days per week 3 or more days per week 0%
*Totals may not add to 100% due to rounding

14% 7% 21 21% 14% 11% 7% 27% 5% 10% 15% 20% 25% 30% n = 28

As part of the baseline evaluation interview, caregivers were asked about youths grades in school*:
Grade Average A's Grade Average A's and B's Grade Average B's Grade Average B's and C's Grade Average C's Grade Average C's and D's Grade Average D's Grade Average D's and F's Grade Average F's Other 8% 15% % 4% 15% % 0% 23% 0% 4% 23% 8% 0%
*Totals may not add to 100% due to rounding

n = 26

5%

10%

15%

20%

25%

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Educational Placements and Individualized Educational Plans (IEP)[a] at Intake

Educational Placements
Educational Placements in the 6 Months Prior to Intake[b] (n = 26)

Regular Public Day School Regular Private Day/Boarding School Home Schooling [c] Home based instruction [c] Alternative/Special Day School School in 24-Hour Psychiatric Setting [d] School in 24-Hour Justice Setting [d] School in 24-Hour Residential 0% Postsecondary School 0% Preschool Head Start n = 28 Other 0% 0% 0% 7% 20% 40% 60% 80% 0% 4% 0% 0% 11% 4%

89%

100%

[a] Data reported were collected using the Education QuestionnaireRevision 2 (EQR2). This instrument collects data on the status of the child/family in the 6 months prior to the interview. [b] Because individuals may have more than one educational placement, educational placements may sum to more than 100%. [c] Includes home-based instruction and combination of home schooling and home-based instruction. [d] Includes hospital, juvenile justice facility, residential treatment center, group home, and group shelter.

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Individualized Educational Plans

Caregivers reported that 48% of youth had an Individualized Education Plan (n=27).

Main Reasons for IEP[a] (n = 13) Behavioral/Emotional Problems Learning Disability Developmental Disability or Mental Retardation Vision or Hearing Impairment Speech Impairment Physical Disability Other 54% 39% 0% 0% 8% 0% 0%

[a] Because individuals may have more than one reason for having an IEP, the reasons for having an IEP may sum to more than 100%.

Special Education Placements at Intake

Caregivers reported that 43% of youth received Special Education services (n=28).

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School Disciplinary Actions at Intake [a]

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Suspended Expelled 8% 0% Suspended and Expelled Neither Suspended nor Expelled 16%

Disciplinary Actions in the 6 Months prior to Intake

76%

n = 25 [a] Data reported were collected using the Education QuestionnaireRevision 2 (EQR2). This instrument collects data on the status of the child/family in the 6 months prior to the interview.

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Criminal Justice History at Intake for Saginaw MAX Services

60% % of youth reported some type of criminal justice contact prior to intake (n = 20). 85% % of youth reported engaging in some type of delinquent or illegal behavior at intake (n = 18).

As part of their evaluation interview, youth were asked:

Have you ever been . . .? ?
Questioned by the police* Arrested Told to appear in court* Convicted (found guilty or adjudicated of a crime)
0% 20% 20% 20% youth self reports (Baseline) = 20 50%

25% 40% 60%

* because you were suspected of committing a crime. (Responses may include some who were questioned, and subsequently arrested, but generally responses indicate those questioned only, without arrest.)

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Substance Use[a] Prior to Intake 70% of youth reported using at least one substance prior to intake (n = 20). Ever Used Average Age of First Use (Years)

Substance[b]

Alcohol Cigarette Chewing Tobacco/Snuff Marijuana/Hashish Cocaine (all forms) Hallucinogenics (e.g., LSD, mushshrooms) PCP Ketamine (Special K) MDMA (Ecstasy, X) GHB Inhalants Heroin Methemphetamine (crystal, ice, glass, etc.) Amphetamines/Stimulants Pain Killers (e.g., Darvocet, Vicodin)

45.0% (n = 20) 50.0% (n = 20) 10.0% (n = 20) 60.0% (n = 20) 10.0% (n = 20) 10.0% (n = 20) 0.0% (n = 20) 0.0% (n = 20) 5.0% (n = 20) 0.0% (n = 20) 0.0% (n = 20) 0.0% (n = 20) 5.0% (n = 20) 10.0% (n = 20) 15.0% (n = 20) 11.9 (n = 12) 10.6 (n = 10)

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Substance[b]

Ever Used

Average Age of First Use (Years)

Ritalin, Adderall, Desoxyn Tranquilizers (e.g., Valium, Xanax) Barbiturates/Sedatives (e.g., Seonol, Nembutal) Non-Prescription/OTC (e.g., diet pills, No-Doz)

25.0% (n = 20) 10.0% (n = 20) 0.0% (n = 20) 5.0% (n = 20)

[a] Information was gathered from the Substance Use SurveyRevised (SUSR). [b] Shaded areas indicate categories with fewer than 10 youth responses; data were not presented for these substances.

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What emotional and behavioral problems are youth experiencing? [a]

Internalizing and Externalizing Scores[b]
100.0 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 Internalizing Behaviors Externalizing Behaviors (n = 28)
[a] Data reported were collected using the Child Behavioral Checklist 618 (CBCL 618). The CBCL measures behavioral and emotional problems during the 6 months prior to data collection. [b] Internalizing and externalizing scores above 63 are in the clinical range.

Average CBCL Problem Scores

Intake 67.4 72.3

Internalizing behaviors at intake are in the clinical range. o Internalizing behavior problems are defined as a child/youths attempts to control painful emotions. Examples include social withdrawal, demand for attention, feelings of worthlessness or inferiority, and dependency. Externalizing behaviors are also in the clinical range. o Externalizing behavior problems are defined as behaviors resulting from a child/youth acting out in response to painful emotions or experiences. Examples include difficulties with interpersonal relationships and rule breaking as well as displays of irritability and belligerence.

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What emotional and behavioral problems are youth experiencing? [a,b]

Withdrawn Somatic (Physical) Complaints* Anxious/Depressed** Social Problems*** Thought Problems**** Attention Problems Rule Breaking Behaviors Aggressive Behavior 55 60 65 70 75 68 70 75 80 64 70 Intake
(n=28)

66 66 67

[a] Data reported were collected using the Child Behavioral Checklist 618 (CBCL 618). The CBCL measures behavioral and emotional problems during the 6 months prior to data collection. [b] Scores on the eight syndrome scales above 70 are in the clinical range. * Somatic complaints are physical problems and include dizziness, tired, aches, headaches, nausea, vomiting, and complaints about eyes, skin or stomach problems. ** Anxious/depressed include loneliness, crying, fear, perfectionism, worthlessness, nervousness, fear, guilt, suspiciousness, sadness and worries. *** Social problems refer to whether the child acts young, clings, doesn't get along with peers, is disliked, acts clumsily, acts young for his age, or prefers to play with much younger children. **** Thought problem items include seeing things, hearing things, staring, strange behavior or ideas and repeating acts.

Thought problems, rule breaking and aggressive behaviors are in the clinical range.

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What are youths emotional and behavioral strengths? [a]

The overall strength index is 79.8 (n = 28). This is lower than the average index of between 90 and 110. With the exception of affective strength and career strength, all of the subscales were rated below the average score of 8 and 12.
[b]

Strength Subscale

Interpersonal Strength Family Involvement Intrapersonal Strength School Functioning Affective Strength Career Strength* 0.0 2.0 4.0 6.0 6.0

6.6 6.8 7.8 Intake

8.2 9.9 8.0 10.0 12.0

*n = 27 n = 28

[a] Data reported were collected using the Behavioral and Emotional Rating ScaleSecond Edition, Parent Rating Scale (BERS2C). The BERS2C reflects behavioral and emotional strengths during the 6 months prior to data collection. [b] Strength subscales on the BERS2C range from 1 to 16, with an average score between 8 and 12. Higher scores indicate greater strength. [c] Strength index on the BERS2C ranges from 38 to 161 with an average index between 90 and 110. A higher index indicates greater overall strengths.

Interpersonal Strength, measures a childs ability to regulate his or her emotions and behaviors in social settings (e.g., "uses anger management skills", "shares with others and apologizes to others when wrong"). Family Involvement evaluates the quality of the relationship between the child and his or her family (e.g., "interacts positively with parents", "complies with rules at home"). Intrapersonal Strength measures a childs perception of his or her competence and accomplishments (e.g., "enjoys a hobby", "is popular with peers"). School Functioning assesses a childs competence in school (e.g., "pays attention in class" and "completes tasks on time"). Affective Strength assesses on the childs ability to express feelings and accept affection from others (e.g., "acknowledges painful feelings," "asks for help").

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Caregiver Strain
Caregiver Strain Questionnaire (CGSQ): The CGSQ assesses the extent to which caregivers are affected by the special demands associated with caring for a child with emotional and behavioral problems. The CGSQ is comprised of three subscales which range in severity from 0 to 5. Higher scores on each of these scales indicate greater strain. Objective Strain refers to observable disruptions in family and community life (e.g., interruption of personal time, lost work time, financial strain). Subjective Externalized Strain refers to negative feelings about the child such as anger, resentment, or embarrassment. Subjective Internalized Strain refers to the negative feelings that the caregiver experiences such as worry, guilt, or fatigue. A Global Strain score is calculated by summing the three subscales (i.e., Objective Strain, Subjective Externalized Strain, and Subjective Internalized Strain) to provide an indication of the total impact of the special demands on the family. Global Strain scores range from 0 to 15. As with the individual subscales, higher scores indicate greater strain.
Caregiver Strain Questionnaire Subscales[a] Objective Strain (n = 27) Subjective Externalized Strain (n = 27) Subjective Internalized Strain (n = 27) Global Strain (n = 27) Average Score 2.7 2.6 3.6 8.9 Range 1 to 5 1 to 5 1 to 5 1 to 15

June 2013