National Survey by the ASSOCIATION OF PUBLIC AND PRIVATE DEVELOPMENTAL DISABILITIES ADMINISTRATORS and the UNIVERSITY OF MINNESOTA of
PUBLIC RESIDENTIAL FACILITIES AND SPECIAL UNITS FOR PERSONS WITH INTELLECTUAL DISABILITIES AND RELATED DEVELOPMENTAL DISABILITIES (IDD)
Fiscal Year 2012 (July 1, 2011 – June 30, 2012)
Facility Name: ______State: ______
Name of Person completing this survey: ______
Phone: ______Email: ______
*electronic version available upon request
Please mail, fax or email* the completed survey by October 31, 2012 to: Brooke Nelson RISP Project 204 Pattee Hall, 150 Pillsbury Dr. SE Minneapolis, MN 55455-0223 [email protected] Fax: 612-625-6619
If you have questions about the survey, please contact: Sherri Larson Phone: (612) 624-6024 Email: [email protected] Pat Salmi Phone: (612) 625-9700 Email: [email protected] Drew Smith Phone: (503) 924-3783 x17 Email: [email protected] ______This survey is supported in part by subcontract to the Association of Public Developmental Disabilities Administrators from funds provided to the University of Minnesota, Research and Training Center for Community Living/Institute on Community Integration as part of its cooperative agreement (No. DHHS 09-DN0217/01) with the Administration on Intellectual and Developmental Disabilities, U.S. Department of Health and Human Services to operate the National Residential Information Systems Project.
1 A state residential facility consists of one or more units on a single campus or adjoining property that together serve 16 or more residents with a primary diagnosis of intellectual disability or developmental disabilities (IDD), is staffed by state employees and that provides 24 hour services.
DO NOT include residents living in group homes on non-adjacent property for any of the questions.
1. Total number of residents (including all units and all diagnoses) as of June 30, 2012:...... ______
For all remaining questions count ONLY residents with a primary diagnosis of intellectual and/or developmental disabilities (IDD) who lived in IDD units
2. Between July 1, 2011 and June 30, 2012 how many different people with IDD:
a. Received short-term on-campus respite (e.g., to provide a break for a caregiver) services? ..._____
b. Were admitted only for short-term (90 days or fewer) evaluation or treatment (e.g., behavioral crisis, medication adjustment, court ordered evaluation)...... _____
c. Were admitted only for a short-term stay (90 days or less) for crisis housing (e.g., during or following a natural disaster or if a primary caregiver dies unexpectedly)? ...... _____
For all remaining questions DO NOT include people who were admitted only for respite, short-term evaluation or treatment, or crisis housing.
3. For Fiscal Year 2012 (July 1, 2011 to June 30, 2012):
a. Number of residents at beginning of year (July 1, 2011) ______b. New admissions (Use this total on page 3) + ______c. Readmissions (Use this total on page 4) + ______(prior residents of this facility)
d. Discharges (Use this total on page 5) - ______e. Deaths (Use this total on page 5) - ______f. Number of residents at end of year (June 30, 2012) (Please use this total on Questions 3 and 4) = ______g. Average daily population of residents with IDD ______
2 Current Resident Characteristics
4a. Level of intellectual disability Please indicate the number of persons with each level of intellectual disability who 1) lived in the facility on June 30, 2012; and the number of people with IDD of each age who between July 1, 2011 and June 30, 2012 who were 2) newly admitted; 3) readmitted; or 4) discharged during this fiscal year. The totals for each column should match the numbers you reported on questions 3f, 3b, 3c and 3d. (DO NOT include respite care, short-term admissions and off-campus residents):
Number of Individuals with IDD 3. Readmissions 4. Discharges 1. Lived in the 2. New Admissions Level of (between July 1, (between July 1, facility on June (between July 1, Intellectual 2011-June 30, 2011- June 30, 30, 2012 2011-June 30, 2012) Disability 2012) 2012) None Mild Moderate Severe Profound Unknown Total
4b. Age Please indicate the number of persons with IDD of each age who 1) lived in the facility on June 30, 2012; and the number of people with IDD of each age who between July 1, 2011 and June 30, 2012 who were 2) newly admitted; 3) readmitted; or 4) discharged during this fiscal year. The totals for each column should match the numbers you reported on questions 3f, 3b, 3c and 3d. (DO NOT include respite care, short-term admissions and off-campus residents):
Number of Individuals with IDD 3. Readmissions 4. Discharges 1. Lived in the 2. New Admissions (between July 1, (between July 1, facility on June (between July 1, Chronological 2011-June 30, 2011- June 30, 30, 2012 2011-June 30, 2012) Age 2012) 2012) 0-14 15-18 19-21 22-39 40-54 55-62 63+ Total
3 Characteristics of New Admissions, Readmissions, & Discharges (DO NOT include respite care, short-term admissions and off-campus residents)
5. Please indicate the previous placement of residents with IDD 1) newly admitted and 2) readmitted; and 3) the new placement for residents discharged from July 1, 2011 to June 30, 2012
A. New B. C. Discharges Admissions Readmissions Facility Type (Previous Residence) (New Residence) a Independent living (no supervision) Supported living/semi-independent living (part- b time supervision) c Home of Parents/Family Member d Foster/family care home e IDD residential facility with 1 to 6 residents f IDD residential facility with 7 to 15 residents g Private IDD residential facility with 16+ residents h Public IDD residential facility with 16+ residents i Boarding home (board/lodge; board/care) j Nursing home Hospital/institution for persons with mental k illness l Correctional facility m Other (Please specify) n Unknown TOTAL:
6. Of the residents with IDD on June 30, 2012 how many were male and how many were female?
______males + ______females = ______total
7. How many residents with IDD on June 30, 2012 had the following additional diagnoses or conditions:
a. Blind (little/no useful vision) ...... ………...... ______b. Deaf (little/no useful hearing) ...... ______c. Epilepsy ...... ______d. Cerebral palsy ...... ______e. Behavior disorder (requiring special staff attention) ...... ______f. Psychiatric disorders (requiring psychiatric attention)...... ______g. Autism spectrum disorders (including Aspergers)……...... ______h. Alzheimer’s or other dementia ...... ______i. Two or more of the above conditions in addition to Intellectual Disabilities ______j. Receives medication for moods, anxiety or behavior ...... ______
4 8. How many residents with IDD as of June 30, 2012 have the following limitations?
a. Cannot walk without assistance or supervision ...... ______b. Cannot dress self without assistance or supervision ...... ______c. Cannot feed self without assistance or supervision ...... ______d. Cannot understand simple spoken requests ...... ______e. Cannot communicate basic desires verbally ...... ______f. Cannot use the toilet without assistance or supervision...... ______g. Cannot get into and out of bed without assistance or supervision...... ______
9. Services to people with IDD involved with the criminal justice system. Please indicate the number of residents as of June 30, 2012 who:
a. Live at this facility because of behaviors that led to involvement of the criminal justice system ...... ______b. Were admitted to this facility for court ordered competency training...... ______c. Have been found incompetent to stand trial...... ______d. Are under parole supervision...... ______e. Are otherwise under the jurisdiction of a criminal court...... _____
Community Services Provided 10. Please check (√ ) any service you offer directly to persons with IDD not living in this facility or indirectly through training and technical assistance to community agencies, families, schools, etc. If no services offered, please check option “t. no services provided to nonresidents”. Directly to persons Indirectly through with IDD in the training/technical Service Provided to Nonresidents of Facility community assistance to agencies a. Assistive technology assessment and intervention b. Audiological assessment and intervention c. Behavioral assessment and intervention d. Crisis support services e. Consultant health services f. Dental services g. Diagnostic services h. Family support/home visitation by staff i. Medical and/or nursing treatment j. Personal/Social counseling k. Physical therapy l. Primary health care m. Recreation/Leisure n. Respite o. Self-help or developmental classes p. Sex education q. Speech services r. Vocational training s. Other (specify) t. No services provided to nonresidents
5 Administration
11. Please record the following budgetary information for the period July 1, 2011 to June 30, 2012 (If this is an IDD unit of a psychiatric or other type of facility, please report for IDD units only).
a1. Personnel Costs (include fringe benefits) ...... $ ______
a2. Other Operating Costs (not including remodeling, construction or repairs)...... $ ______
a3. Total Operating Cost (not including remodeling, construction or repairs) ...... $ ______
b. Average per diem cost from July 1, 2011 to June 30, 20121...... $______
12. As of June 30, 2012, please list the number of full-time equivalent (FTE) employees of this facility by job type. Include all full-time, part-time, contracted, and all other workers with regularly scheduled hours. (One FTE is 40 hours worked in a week. One FTE could represent one person working 40 hours, two people working 20 hours, or any other combination hours adding up to 40 in a week).
Staff Role Selected Examples N FTEs a Physicians and Nurses MD, OD, RN, LPN, LVN, PA, etc. b Degreed or Licensed OT, PT, Speech, Recreation Therapist Therapists c Degreed or Licensed Educators Special Education Teacher (K-12) d Other Degreed or Licensed Psychologist, Behavior Analyst professionals e Direct Support Staff Aides, Assistants, Technician, Job Coach, Residential Counselor, day program staff, vocational staff, etc. F Administrators and Managers Director, CEO, Program Director, Unit Manager, Supervisors (who are not considered direct support staff) g All other staff Laundry, maintenance, cooks, drivers, security, business office and similar positions Total full-time equivalent staff (Sum of A-G)
Direct Support Staff (e.g., Aides, Assistants, Technicians, Job Coach, Residential Counselor, Day Program Staff, Vocational Staff, etc.) Please refer only to those people counted as direct support staff (Category 12e).
13. Counting all shifts, how many direct support staff members (including full-time and part-time, but not including “on-call”) worked specific regular shifts in your facility as of June 30, 2012 (This is the number of people filling the FTE hours reported in 11e)? ...... ______
14. How many direct support staff were employed full-time as of June 30, 2012? ...... ______
1 “Average per diem cost” means the average cost of care of one resident for one day. 6 15. What is the current average starting hourly wage for direct support employees?.$______per hour
16. What is the average hourly wage of all current direct support employees?...... $______per hour
17. How many hours per week must a direct support staff member work to be eligible for paid leave time (e.g., sick, holiday, personal leave)? ...... ______hours per week
18. How many direct support staff members are eligible for paid leave? ...... ______# of workers
19. Counting all shifts, how many direct support staff left their positions (e.g., resigned, retired, were fired, transferred or were promoted to non-direct support position) between July 1, 2011 and June 30, 2012? ...... ______
20. How many direct support staff positions are funded but currently vacant (i.e., how many direct support staff do you need to hire to be fully staffed today)?...... ______
21. Which of the following are the biggest staffing related concerns for your facility? (Please mark up to three choices)
_____ a. Direct support staff motivation _____ f. Coworkers do not get along _____ b. Direct support staff training and _____ g. Workers dissatisfied with supervisors development _____ h. Morale problems _____ c. Direct support staff turnover _____ i. Direct support staff wages and benefits _____ d. Finding qualified direct support staff _____ j. None of the above _____k. Other (specify)______e. New hires quit during the first 6 months Frontline Supervisors Frontline supervisors (FLS) are people who directly supervise direct support staff. FLS have a variety of job titles but spend less than 50% of their total hours providing direct supports to people with IDD. In your facility, counting all shifts:
22. How many people (including full-time and part-time) worked in frontline supervisor roles directly supervising direct support staff as of June 30, 2012?...... ______
23. How many frontline supervisors left their positions (e.g., resigned, retired, fired, promoted) between July 1, 2011 and June 30, 2012? ...... ______
24. How many frontline supervisor positions are currently funded but vacant (How many people do you need to hire in frontline supervisor roles to be fully staffed today?) ...... ______
25. What is the current average annual starting salary of frontline supervisors?.....$______per year
26. What is the current average annual salary of all frontline supervisors?...... $______per year
Closure
27. a. Is your facility scheduled for closure? Yes No
7 b. If yes, by what year? Which month?______
Thank you for your continued support of this survey
Please fax, mail or email your survey to the person listed on the front cover of this survey or complete the online version of the survey by October 31, 2012.
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