Observations
Based on a review of the Active Client List form which is completed weekly by the facility, and a discussion with the project director and the treatment supervisor on May 19, 2010, the facility failed to ensure that staff to client caseloads remained at or under 35:1.
The findings included:
The Active Client List form is completed weekly and is a listing of each counselor and supervisor and their caseload. This list was reviewed for the time frame from July 13, 2009 to May 19, 2010. During the time frame between July 13, 2009 to May 19, 2010, there are fourteen staff members listed. Based on the number of hours the employee worked at this facility, and the number of clients on the counselors' caseload, eight counselors' caseloads exceeded 35:1 at some time during that period. The counselors represented by personnel records # 1, 2, 3, 4, 5, 6, 7 and 8 had caseloads exceeding 35:1 at some time during that period.
A discussion with the project director and a telephone conference with the treatment supervisor confirmed that the caseloads exceeded the limitations of 35 clients to 1 counselor during the time period reviewed.
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Plan of Correction
In regards to 704.12, as of 6-7-10 FCDAC will adhere to the 35:1 ratio patient case load. The Treatment supervisor in conjunction with the assistant executive director will review weekly, the number of active clients that are assigned to each counselor. In order to monitor the 35:1 ratio as stated in 704.12 the Treatment Supervisor will review, on a bi-weekly basis the list of the active clients that have not been seen for services in the past 30 days. Clients that have not received services within that time period will be immediately discharged. However, if the client cannot be discharged, then they will be immediately transferred to another counselor who does not exceed the 35:1 ratio.
In order to maintain compliance with 704.12, FCDAC will continue to closely monitor the active client list that is produced weekly. Should the need arise; a temporary waiting list of potential consumers seeking treatment through FCDAC will be created. This temporary waiting list will ensure that all clients currently receiving services will be given the opportunity to experience adequate treatment offered by FCDAC.
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