Halfway House Data Form

Human Services Block Grant Data Tracking   
Halfway House Data Required  
 Provider Name: 
 Select Month: 
 Number of clients that began  treatment:  
 Number of clients that completed  treatment:  
Percentage of clients (of # 1) that completed treatment (#2 divided by #1):  
Of # 2 (clients that completed treatment), number engaged in aftercare within seven (7) days of halfway house completion.   
Percentage (%) of clients engaged in aftercare within 7 days (#4 divided by #2)  
 Submitter Name:  
 Submitter Email:   
 Submitter Telephone:  
    
 
 
Instructions:
 
1.  Number of clients that were admitted to and began treatment this month.
 
2.  Number of clients that completed treatment – completed is defined as not
leaving against medical advice or due to program infraction/behavior.
 
3.    Percentage (%) that completed  treatment.  The percentage is calculated by
dividing #2 (number of clients that completed treatment)
by #1 (number of clients that were admitted to/began treatment).
 
4. Of # in 2 (clients that completed treatment), number engaged in follow-up
treatment/after care within seven (7) days.  Follow-up treatment is
defined as engaged in an appropriate of care as assessed via PCPC or a lessor level of care requested
by the client and agreed to by the provider.  If slightly beyond
7 days due to appointment availability this can be included as within seven days.  
 
5.  Percentage (%) that completed and began follow-up treatment with 7 days
– The percentage is calculated by dividing #2
(number of clients that began follow-up treatment within 7 days by #1 (number of clients that completed inpatient).
follow-up tratment is defined as engaged in an appropriate of care as assessed via PCPC or a lessor level of care requested
by the client and agreed to by the provider.  If slightly beyond 7 days due to appointment availability this can be included as within seven days.
 
It is noted that some individuals may not be able be admitted to outpatient care within 7 days because of lack of
available slots at outpatient provider facilities.  However, 7 days appear to be the standard in which all providers
are required to do a follow-up so it may be best to use that number for this purpose because it is consistent across all providers.
 
Please define unsuccessful vs. successful completion.  In other words, individuals may be discharged for various reasons
(dismissed for program violation, moved, etc…), so indicate those accordingly.
 
Specify service as either short-term (30 or less days) or long-term (more than 30 days).