2012 Report - Elder Affairselderaffairs.org/doea/pubs/pubs/2012 CSS - PSA 4 Report.pdf · This...

RICK SCOTT GOVERNOR

CHARLES T. CORLEY

SECRETARY

elderaffairs.state.fl.us

2012 Report

Client Satisfaction Survey

Program Services, Direct Service Workers, and

Impact of Programs on Lives of Clients

PSA 4

Bureau of Planning & Evaluation, October 2013

2012 Client Satisfaction Survey: PSA 4

Table of Contents

Executive Summary ............................................................................................................................................... 2

Background ............................................................................................................................................................... 3

Methodology ............................................................................................................................................................ 3

Population and Sample ..................................................................................................................................... 3

The Survey ............................................................................................................................................................ 4

Survey Procedures .............................................................................................................................................. 4

Analysis ................................................................................................................................................................. 4

Survey Results ......................................................................................................................................................... 5

Overall Satisfaction With Services Received and With Their Quality .............................................. 5

Client Satisfaction With Program Service Delivery ................................................................................. 6

Client Satisfaction With Direct Service Workers .................................................................................... 8

The Impact of Services on Clients’ Lives .................................................................................................... 10

Summary and Conclusions ................................................................................................................................. 10

Appendix A: Understanding Your Tables ...................................................................................................... 11

Appendix B: PSA 4 and Statewide Survey Responses ................................................................................ 13

Appendix C: Survey Instrument ....................................................................................................................... 16

Appendix C: Survey Instrument ....................................................................................................................... 16

1 2012 Client Satisfaction Survey: PSA 4

Executive Summary

In 2012, the Florida Department of Elder Affairs (DOEA) Bureau of Planning and Evaluation

surveyed a random sample of clients that was based on their participation in three of the

Department’s community-based care programs in each of the state’s 11 Planning and Service

Areas (PSAs). The following report examines responses obtained from PSA 4 clients and

compares them to responses for all 11 PSAs surveyed.

The purpose of the surveys was to assess the satisfaction of clients with program services, the

quality of direct service workers, and the impact of the program on clients’ lives. Clients selected

for the surveys participated in at least one of three DOEA programs serving the largest number

of case-managed clients: Aged and Disabled Adult Medicaid Waiver (ADA), Assisted Living

Medicaid Waiver (AL), and Community Care for the Elderly (CCE).

Program participants in PSA 4 reported high levels of overall satisfaction with program services,

their quality and delivery. They also reported high levels of satisfaction with their direct service

workers and the impact of services on their lives.

The combined response options of Very Satisfied and Satisfied yielded high overall levels of

satisfaction with PSA 4 services received and with their quality (98% and 97%, respectively).

The level of satisfaction reported by clients statewide was 96 percent for both of these service

aspects

The majority of respondents were satisfied with the aspects of program services queried

including frequency and length of services, time of day, and day(s) of the week. Between

95 and 99 percent of ADA, AL, and CCE respondents reported being Very Satisfied or

Satisfied with these provisions of program services.

The majority of respondents were also Very Satisfied or Satisfied with their direct service

workers. Between 89 and 99 percent of respondents surveyed in PSA 4 were Very

Satisfied or Satisfied with their direct service workers, with the lowest percentage

pertaining to the issue of worker continuity or the ability to expect the same worker to

come each time (89%).

Survey respondents reported that program services had a major impact on their lives.

Between 97 and 98 percent of respondents said services met their needs, improved their

quality of life, and increased the likelihood of their remaining in their homes.

When comparing satisfaction levels of PSA 4 respondents to those compiled from responses

statewide, PSA 4 results were very similar and differed by less than one to three percent.

3 2012 DOEA Client Survey – PSA 4

Background

The Florida Department of Elder Affairs operates a variety of programs to meet the special needs

of Florida’s aging citizens. These programs are designed to provide cost-effective ways of

keeping elderly persons in their homes or communities and to prevent, postpone, or reduce

inappropriate or unnecessary institutional placements.

Individuals served by these programs are frail elders and persons with disabilities who are

functionally impaired and at risk of nursing home placement. CARES (Comprehensive

Assessment and Review for Long-Term Care Services) is Florida's federally mandated nursing

home pre-admission assessment program that determines medical eligibility for the Medicaid

waiver programs. Individuals must be age 60 or older and meet the same functional and financial

criteria as individuals seeking Medicaid assistance for nursing home placement to qualify for the

ADA and AL programs administered by the Department. In addition, for AL eligibility,

individuals must meet at least one of the following additional criteria: require assistance with

activities of daily living, be diagnosed with Alzheimer's disease or other dementia(s), have a

diagnosis of a degenerative or chronic medical condition requiring nursing services, or be

waiting for discharge from a nursing home and unable to return to a private residence.

Individuals eligible for CCE must be age 60 or older and functionally impaired. Primary

consideration for CCE services is given to elderly persons reported to Adult Protective Services

(APS) and determined by APS to be victims of abuse, neglect, or exploitation who are in need of

immediate services to prevent further harm.

Services provided to participants of the above-mentioned programs may include personal care,

homemaker, adult day health care, home-delivered meals, companionship, case management,

case aide, chore, escort, respite, attendant care, and counseling.

Methodology

Population and Sample

The three DOEA programs selected for the survey (ADA, AL, and CCE) are those which serve

the largest number of case-managed clients. The clients selected for the survey received services

from one of these programs for at least three months and received a service in addition to case

management and home-delivered meals.

Samples were taken from each of Florida’s 11 PSAs. The samples were stratified to represent the

proportion of clients in each PSA and the proportion of clients in each program. The sample size

for PSA 4 is large enough to assume a 90 percent confidence level for the representativeness of

results.


The Survey

The survey contained 15 questions for recipients of program services, of which 11 evaluated

services and direct service workers and three addressed the impact of services on respondents’

lives. Questions assessing satisfaction with services included those on the frequency, length,

time of day, day(s) of the week, and quality of services provided. Questions assessing

satisfaction with direct service workers focused on adequacy of worker knowledge and skills,

communication with workers, treatment of clients, punctuality, and continuity of services

conducted by the same worker. Three questions addressing the impact of services on the lives of

clients asked respondents whether services met their needs, helped to maintain or improve their

quality of life, and helped them continue living in their home. A final question gave respondents

the opportunity to volunteer any other information about the services they received. This report

includes the survey instrument as Appendix C.

Survey Procedures

Clients were sent letters notifying them that they might be called to participate in a survey

about the services they received. They were assured that, whether or not they participated, their

DOEA program services would not be affected.

The survey was conducted between September 5 and 27, 2012, by professional interviewers in

the DOEA Computer-Assisted Telephone Interview (CATI) Call Center. Instructions informed

respondents that the survey would take an estimated 10 minutes to complete. The calls resulted

in 316 completed surveys, yielding a response rate (the number of surveys completed divided by

all eligible persons successfully contacted) of 40 percent. A large number of clients were unable

to respond to the survey because of unavailability (e.g., hospitalization) or inability to hear,

understand, or remember.

Analysis

The number of completed surveys was weighted within programs in each PSA to compensate for

over and under-sampling and to be representative of the PSA 4 client population surveyed. Data

were collapsed across programs and analyzed for each PSA and for all 11 PSAs combined.

Appendix B contains the response distribution, arithmetic means, and standard deviations for

each question, for PSA 4 and across all 11 PSAs. Appendix A offers instructions on how to read

the tables and interpret statistical terms included in the report.


Survey Results

Overall Satisfaction With Services Received and With Their Quality

Clients expressed high overall satisfaction with the services and with the quality of services they

received. The combined response options of Very Satisfied and Satisfied yielded high overall

levels of satisfaction with program services by PSA 4 respondents and by all respondents in the

11 PSAs (at least 96% for each question).

Overall Client Satisfaction With Services

Received

PSA 4 survey respondents expressed high levels

of overall satisfaction with services received.

Sixty-four percent said they were Very Satisfied,

and an additional 33 percent said they were

Satisfied.

The satisfaction levels of PSA 4 clients were

similar to those achieved for all clients surveyed

statewide. The combined response options of

Very Satisfied and Satisfied for PSA 4 and

statewide clients yielded high overall levels of

satisfaction with services received (98% and

96%, respectively).

Overall Client Satisfaction With the Quality of Services Received

PSA 4 survey respondents expressed high

levels of satisfaction with the quality of

services received. Fifty-six percent said they

were Very Satisfied, and an additional 42

percent said that they were Satisfied.

The satisfaction levels of PSA 4 clients were

similar to those achieved for all clients

surveyed statewide. The combined response

options of Very Satisfied and Satisfied for PSA

4 and statewide clients yielded high overall

levels of satisfaction with the quality of services received (97% and 96%, respectively).


Client Satisfaction With Program Service Delivery

Four questions asked survey respondents about their satisfaction with program services.

How satisfied are you with how often services are provided?

How satisfied are you with the length of service visits?

How satisfied are you with the time of day that services are provided?

How satisfied are you with the day(s) of the week services are provided?

PSA 4 respondents expressed high levels of satisfaction with the surveyed aspects of program

services, which were very close to those reported by all clients surveyed in the 11 PSAs. The

combined response options of Very Satisfied and Satisfied yielded high overall levels of

satisfaction with aspects of program services by PSA 4 respondents and by all respondents in

the 11 PSAs (at least 92% for each question).


Satisfaction With Frequency of Services Provided

PSA 4 survey respondents expressed high levels of satisfaction with frequency of services

provided. Fifty-three percent said they were Very Satisfied, and an additional 43 percent said

that they were Satisfied.

The satisfaction levels for service frequency for PSA 4 participants were very close to those

reported by all clients surveyed in the 11 PSAs. The combined response options of Very Satisfied

and Satisfied yielded high overall levels of satisfaction with service frequency by PSA 4

respondents and by all respondents in the 11 PSAs (96% and 95%, respectively).

Satisfaction With Length of Service Visits

PSA 4 survey respondents expressed high levels of satisfaction with the length of service visits.

Forty-three percent said they were Very Satisfied, and an additional 53 percent said that they

were Satisfied.

The combined response options of Very Satisfied and Satisfied clients yielded high levels of

overall satisfaction with the length of service visits for PSA 4 and statewide clients (95% and

92%, respectively).

Satisfaction With the Time of Day Services Are Provided

PSA 4 survey respondents expressed high levels of satisfaction with the time of the day services

were provided. Forty-four percent said they were Very Satisfied, and an additional 55 percent

said that they were Satisfied.

A larger percentage of PSA 4 clients (44%) than statewide clients (37%) reported they were

Very Satisfied with the time of day their services were provided. The combined response options

of Very Satisfied and Satisfied for PSA 4 and statewide clients yielded high overall satisfaction

with the length of service visits (99% and 96%, respectively).

Satisfaction With the Day of the Week Services Are Provided

PSA 4 survey respondents expressed high levels of satisfaction with the day of the week services

were provided. Forty-seven percent said they were Very Satisfied, and an additional 52 percent

said that they were Satisfied.


Very Satisfied. The combined response options of Very Satisfied and Satisfied for PSA 4 and

statewide clients yielded high overall satisfaction levels with the day of the week of service

delivery (99% and 97%, respectively).


Client Satisfaction With Direct Service Workers

PSA 4 survey respondents expressed high levels of satisfaction with different aspects of their

direct service workers. The combined response options of Very Satisfied and Satisfied ranged

from 89 to 99 percent.

Client Satisfaction With the Knowledge and Skills of Direct Service Workers

Fifty-four percent said that they were Very Satisfied with the knowledge and skills of their

workers, and an additional 42 percent said they were Satisfied. The combined response options

of Very Satisfied and Satisfied for PSA 4 and statewide clients yielded high overall levels of

satisfaction with worker knowledge and skills (96% and 95%, respectively).

Client Satisfaction With Treatment by Direct Service Workers

Sixty-three percent of PSA 4 clients said they were Very Satisfied, and an additional 36 percent

said that they were Satisfied with treatment by workers.


Very Satisfied. The combined response options of Very Satisfied and Satisfied for PSA 4 and

statewide clients yielded high overall levels of satisfaction with their treatment by workers

(99% and 98%, respectively).


Client Satisfaction With the Ability to Communicate With Direct Service Workers

Sixty-two percent of the PSA 4 survey respondents said they were Very Satisfied with worker

communication, and an additional 37 percent said they were Satisfied.


Very Satisfied. The combined response options of Very Satisfied and Satisfied yielded high

overall levels of satisfaction with worker communication for PSA 4 and statewide clients (99%

and 97%, respectively).

Punctuality and Continuity of Direct Service Workers

Ninety-three percent of PSA 4 clients said their workers arrived at the scheduled time compared

to 95 percent of statewide clients.

Even though the proportion of clients who said they did not know when to expect workers was

small, PSA 4 clients were one-fourth times less likely to give this response than statewide clients

(0.3% and 1.2%, respectively).

The percentage of PSA 4 clients who reported that the same worker usually comes to help was

89 percent for PSA 4 clients compared to 93 percent for clients across the 11 PSAs.


The Impact of Services on Clients’ Lives

Program recipients were also asked to indicate whether the services met their needs, improved

their lives, and helped them stay at home.

The percentage of PSA 4 clients and statewide clients who reported that services met their

needs was 97% for each group. PSA 4 and statewide clients were highly likely to say that

services helped maintain or improve their quality of life (98% and 97 %, respectively).

Approximately 98 percent of PSA 4 and statewide clients said that services helped them stay in

their home.

Summary and Conclusions

In summary, program participants in PSA 4 reported high levels of overall satisfaction with the

services they received through the ADA, AL, and CCE programs and the quality and delivery of

these services. In addition, they were highly satisfied with their direct service workers and the

impact of services on their lives. Survey participants’ combined responses of Very Satisfied and

Satisfied yielded overall satisfaction levels with these service aspects ranging from 89 to 99

percent

When comparing satisfaction levels of PSA 4 respondents to those compiled from responses

statewide, PSA 4 results were very similar and differed by less than one to three percent.


Appendix A: Understanding Your Tables

Responses

Sample PSA

All PSAs

Frequency Percent Mean

Standard

Deviation Frequency Percent Mean

Standard

Deviation

Very Satisfied (5) 69 27.6

4.2 0.621

1,077 44.5

4.35 0.715

Satisfied (4) 170 67.9

1,215 50.2

Neither Satisfied nor

Dissatisfied (3) 3 1.1

44 1.8


71 2.9

Very Dissatisfied (1) 0 0

14 0.6

Total 250 100

2,422 100

Answer choices and point

value (1-5) for the

response

The number of

clients choosing

this response

Percent of clients

choosing a response

The mean or item

score. The average of

all client responses.

The same information

is given for all 11 PSAs

combined

The variation among the responses. A low

standard deviation indicates the responses

tend to be very close to the mean. A high

standard deviation indicates that the

responses are more spread out.


Look At Your Results:

5. Overall, how satisfied are you with the quality of the services you have received?

Responses

Sample PSA

All PSAs


Standard

Deviation


Standard

Deviation


4.44 0.66

1,189 48.6

4.41 0.68

Satisfied (4) 90 47.7

1,143 46.8

Neither Satisfied nor

Dissatisfied (3) 1 0.5*

54 2.2


48 2.0

Very Dissatisfied (1) 1 0.6*

10 0.4

Total 189 100

2,444 100

*Percentage differences were created by analysis software.

Of the 189 clients who responded to Question 5 in the sample PSA, 93 (49.5%) said

they were Very Satisfied with the quality of services they received, 90 (47.7%) were

Satisfied, one (0.5%) was Neither Satisfied nor Dissatisfied, three (1.7%) were

Dissatisfied, and one client (0.6%) was Very Dissatisfied.

Overall, a total of 97.2 percent of clients responded that they were Very Satisfied

or Satisfied (49.5% plus 47.7%).

The mean of the responses, or the “Item Score,” was 4.44. The highest score

possible is 5 (for Very Satisfied) and the lowest possible is 1 (for Very Dissatisfied).

The average client in this sample PSA is more than satisfied with the quality of

services he or she receives since the mean is close to 5.

There is some variation in the client responses. This can be seen in the standard

deviation and by looking at the distribution of frequencies.

Compare Your Results to all the PSAs in Florida:

The means of both groups are about the same and show overall satisfaction with

the quality of services. There are slight differences in how satisfied the clients

were. Whereas the sample PSA showed 49.5 percent of clients Very Satisfied,

48.6 percent of clients statewide were Very Satisfied.

The sample PSA had one client who was Very Dissatisfied. There were 10 Very

Dissatisfied clients statewide, but the total is less than one-half percent.


Appendix B: PSA 4 and Statewide Survey Responses

Responses

PSA 4 All PSAs

Number Percent Mean Standard Deviation


1. How satisfied are you with how often services are provided?


4.45 0.68

1,077 44.5

4.35 0.72

Satisfied (4) 99 42.6 1,215 50.2

Neither Satisfied nor Dissatisfied (3)

3 1.4 44 1.8

Dissatisfied (2) 7 3.1 71 2.9

Very Dissatisfied (1) 0 0 14 0.6

Total 232 100.0 2,422 100.0

2. How satisfied are you with the length of the service visits?


4.36 0.65

741 32.9

4.20 0.72

Satisfied (4) 116 52.5 1,336 59.2


5 2.4 76 3.4



Total 221 100.0 2,255 100.0

3. How satisfied are you with the time of day that services are provided?


4.42 0.53

819 36.3

4.20 0.60

Satisfied (4) 121 55.4 1,355 60.2


1 0.7 37 1.6



Total 218 100.0 2,252 100.0

4. How satisfied are you with the day(s) of the week services are provided?


4.46 0.51

818 36.2

4.31 0.61

Satisfied (4) 114 52.2 1,364 60.3


1 0.7 36 1.6

Dissatisfied (2) 0 0 38 1.7


Total 218 100.0 2,260 100.0


Responses

PSA 4 All PSAs





4.51 0.60

1,189 48.6

4.41 0.68

Satisfied (4) 97 41.7 1,143 46.8


3 1.4 54 2.2



Total 232 100.0 2,444 100.0

6. How satisfied are you that your worker(s) has (have) the knowledge and skills needed to help you?


4.48 0.64

1,110 45.6

4.37 0.69

Satisfied (4) 98 42.4 1,199 49.2


4 1.9 57 2.3



Total 231 100.0 2,436 100.0

7. How satisfied are you with the way your worker(s) treat you?


4.60 0.56

1,355 55.6

4.52 0.61

Satisfied (4) 82 35.9 1,025 42.1


1 0.3 26 1.1



Total 229 100.0 2,437 100.0

8. How satisfied are you with the way you and your worker(s) communicate?


4.60 0.55

1,201 49.5

4.44 0.64

Satisfied (4) 85 36.9 1,139 46.9


1 0.6 46 1.9



Total 231 100.0 2,428 100.0

9. Do(es) your worker(s) usually arrive at the scheduled time?

Yes (2) 204 93.1

1.93 0.27

2,095 94.9

1.96 0.29

No (1) 14 6.5 86 3.9

I don't know when to expect them

1 0.3 27 1.2

Total 219 100.0 2208 100.0


Responses

PSA 4 All PSAs



10. Can you usually expect the same person (people) to come help?

Yes (2) 192 89.2

1.89 0.31

2,532 93.0

1.92 0.27 No (1) 23 10.8 191 7.0

Total 215 100.0 2,723 100.0

11. Overall, would you say that the services you receive meet your needs?

Yes (2) 221 96.7

1.97 0.18

2,812 96.8

1.97 0.18 No (1) 7 3.3 92 3.2

Total 228 100.0 2,904 100.0

12. Do these services help you to maintain or improve your quality of life?

Yes (2) 223 97.6

1.98 0.14

2,803 97.3

1.97 0.17 No (1) 5 2.1 79 2.7

Total 228 100.0 2,882 100.0

13. Do these services help you to stay in your home? (If at an ALF ask: Do these services help you to avoid moving into a nursing home?) Would you say:

Yes (2) 220 97.8

1.98 0.15

2,796 97.8

1.98 0.15 No (1) 5 2.2 62 2.2

Total 225 100.0 2,858 100.0

14. Overall, how satisfied are you with the services you receive?


4.60 0.61

1551.0 54.9

4.48 0.66

Satisfied (4) 77 33.3 1168.0 41.4


2 1.1 52.0 1.8

Dissatisfied (2) 3 1.1 39.0 1.4

Very Dissatisfied (1) 1 0.3 13.0 0.5

Total 231 100.0 2,823 100.0


Appendix C: Survey Instrument

Cl ient Satisfact ion Survey

SERVICES

These questions ask about how satisfied you are with the services you receive. You can answer: Very

Satisfied, Satisfied, Neither Satisfied nor Dissatisfied, Dissatisfied, or Very Dissatisfied. You can also tell

me if you really don’t know.

1. How satisfied are you with how often services are provided? a. Very Satisfied b. Satisfied c. Neither Satisfied nor Dissatisfied d. Dissatisfied e. Very Dissatisfied

2. How satisfied are you with the length of the service visits?

a. Very Satisfied b. Satisfied c. Neither Satisfied nor Dissatisfied d. Dissatisfied e. Very Dissatisfied

3. How satisfied are you with the time of day that services are provided?


4. How satisfied are you with the day(s) of the week services are provided? a. Very Satisfied b. Satisfied c. Neither Satisfied nor Dissatisfied d. Dissatisfied e. Very Dissatisfied



WORKERS

Next, I’m going to ask you several questions about how satisfied you are with the workers who come to

help you. Again, you can answer: Very Satisfied, Satisfied, Neither Satisfied nor Dissatisfied, Dissatisfied,

or Very Dissatisfied. You can also tell me if you really don’t know.

6. How satisfied are you that your worker(s) has (have) the knowledge and skills needed to help you? a. Very Satisfied b. Satisfied c. Neither Satisfied nor Dissatisfied d. Dissatisfied e. Very Dissatisfied

7. How satisfied are you with the way your worker(s) treat you? a. Very Satisfied b. Satisfied c. Neither Satisfied nor Dissatisfied d. Dissatisfied e. Very Dissatisfied

8. How satisfied are you with the way you and your worker(s) communicate? a. Very Satisfied b. Satisfied c. Neither Satisfied nor Dissatisfied d. Dissatisfied e. Very Dissatisfied

9. Do(es)your worker(s) usually arrive at the scheduled time? a. Yes b. No c. I don’t know when to expect them


10. Can you usually expect the same person (people) to come help?

a. Yes b. No c. Don’t Know (d. Refused) e. Not Applicable

SERVICE IMPACT

The last set of questions focuses on the effect or impact these services have on your life.

11. Overall, would you say that the services you receive meet your needs? a. Yes b. to some extent c. No d. Don’t Know (d. Refused) e. Not Applicable

12. Do these services help you to maintain or improve your quality of life? a. Yes b. to some extent c. No d. Don’t Know (d. Refused) e. Not Applicable

13. Do these services help you to stay in your home? (If at an ALF ask: Do these services help you to avoid moving into a nursing home?) Would you say: a. Yes b. to some extent c. No d. Don’t Know (d. Refused) e. Not Applicable

14. Overall, how satisfied are you with the services you receive? a. Very Satisfied b. Satisfied c. Neither Satisfied nor Dissatisfied d. Dissatisfied e. Very Dissatisfied

COMMENTS

That’s the end of our questions.

15. Is there anything else you would like us to know about the services you receive?

I want to thank you for participating in the survey.

Your feedback is important to the Department of Elder Affairs.

I hope you have a great day.

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