Section VI: Clinical Measures National Evaluation of the

National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program

Data Profile Report (DPR)

Prepared by the National Evaluation Team, August 2011 Adapted for Orange County by LuAnn McCormick, Lead Evaluator

New York (Orange County)

Section VI: Clinical Measures

New York (Orange County) Data Profile Report August 2011

Data are from the CMHS National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program. This report is based on data submitted through August 10, 2011.

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Section VI: Child Clinical Measures

This section provides clinical information on the children participating in the Longitudinal Outcome Study. Information on functional impairment, depression, and anxiety is presented, along with information on children’s behavioral and emotional problems. Finally, measures of children’s behavioral and emotions strengths are included in addition to measures of adaptive behaviors. Information in this section was taken from the following instruments: Columbia Impairment Scale (CIS): The CIS, administered to caregivers, provides a global measure of impairment. CIS scores range from 0 to 52. Higher scores indicate a greater level of impairment. A score of 15 or higher is considered clinically impaired. Revised Children’s Manifest Anxiety Scale-2nd Edition (RCMAS-2): The RCMAS-2, completed by youth, measures anxiety. The RCMAS-2 is comprised of four subscales: Worry, Social Anxiety, Physiological Anxiety, and the Defensiveness score. The Defensiveness score measures inaccurate self-report. A high Defensiveness score indicate that the respondent is unwilling to admit to common imperfections. Scores for each subscale are converted to standardized scores (T-scores). Higher scores indicate a greater level of anxiety. T-scores greater than 60 indicate respondent has some difficulties with anxiety. Reynolds Adolescent Depression Scale–2nd Edition (RADS–2): The RADS–2, completed by youth, measures adolescent depression. RADS–2 is comprised of four subscales: Dysphoric Mood, Anhedonia/Negative Affect, Negative Self-Evaluation, and Somatic Complaints. Scores are converted to standardized scores (T-scores), and have varying ranges; minimum values range from 29 to 40 and maximum scores range from 76 to 90. Total T-scores of less than 61 represent Normal range, 61 to 64 represent Mild clinical depression range, 65 to 69 represent Moderate clinical depression range, and greater than or equal to 70 represent Severe clinical depression range.



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Section VI: Child Clinical Measures, continued

Child Behavioral Checklist (CBCL 6–18): The CBCL 6–18 is administered to caregivers and measures behavioral and emotional problems in children aged 6 to 18. The CBCL 6–18 produces eight narrow-band syndrome scores: anxious/depressed, withdrawn/depressed, somatic complaints, social problems, thought problems, attention problems, rule-breaking behavior, and aggressive behavior; two broadband syndrome scores: internalizing and externalizing; and a total problem score. T-scores between 65 and 69 (93rd and 97th percentile) on the narrow-band syndrome scales are in the borderline clinical range. T-scores 70 or above are in the clinical range. On the internalizing, externalizing, and total problem scales, T-scores between 60 and 63 (84th and 90th percentile) are in the borderline clinical range. T-scores 64 or above are in the clinical range. The CBCL is also comprised of three competence subscales, as well as a Total Competence scale. Higher scores on the competence scales indicate greater competence. The three competence subscales have a T-score range from 20 to 65, with scores under 30 in the clinical range (i.e., less competence) (2nd percentile), scores between 31 and 36 in the borderline clinical range, and scores over 36 below the clinical range (i.e., greater competence). The Total Competence scale has a T-score range from 10 to 80, with scores under 37 in the clinical range (i.e., less competence), scores between 37 and 40 in the borderline clinical range, and scores over 40 below the clinical range (i.e., greater competence).



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Section VI: Child Clinical Measures, continued

Behavioral and Emotional Rating Scale–Second Edition, Parent Rating Scale (BERS–2C): The BERS–2C is administered to caregivers. It measures children’s emotional and behavioral strengths in six different areas: interpersonal strength, family involvement, intrapersonal strength, school functioning, affective strength, and career strength. Scaled scores on the strength subscales range from 1 to 16, with an average score between 8 and 12. Higher scores indicate greater strengths. A strength index can be calculated and is based on the sum of the subscale scores, excluding career strength. The strength index ranges from 38 to 161, with an average index in the 90–110 range. A higher index indicates greater overall strengths. Behavioral and Emotional Rating Scale–Second Edition, Youth Rating Scale (BERS–2Y): The BERS–2Y is a youth version of the BERS–2C. It is administered to youth 11 years and older. As with the caregiver version, the BERS–2Y measures children’s emotional and behavioral strengths in six different areas: interpersonal strength, family involvement, intrapersonal strength, school functioning, affective strength, and career strength. On the youth version, however, scaled scores on the strength subscales range from 1 to 18, but the average range remains the same at 8–12. The calculation, range, and average score of the strength index remain the same as well (i.e., 38 to 161, with an average index between 90 and 110). Higher subscale scores and strength indexes indicate greater overall strengths.



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Child Impairment and Anxiety and Adolescent Depression at Intake

Measure Average Score Clinical Impairment Range

Columbia Impairment Scale[a]

Overall Level of Impairment (n = 101) 26.0 15.0 – 52.0

Revised Child's Manifest Anxiety Scale[b]

Worry (n = 67) 51.9

Social Anxiety (n = 65) 50.8

Physiological Anxiety (n = 66) 50.2

Total Anxiety Score (n = 65) 51.4 61.0 – 92.0

Reynold's Adolescent Depression Scale–2[c]

Dysphoric Mood (n = 67) 49.9

Anhedonia/Negative Affect (n = 66) 49.1

Negative Self-Evaluation (n = 67) 51.9

Somatic Complaints (n = 67) 52.4

Total Depression Score (n = 67) 51.0 61.0 – 90.0

[a] Data reported were collected using the Columbia Impairment Scale (CIS), the Revised Child’s Manifest Anxiety Scale, Second Edition (RCMAS-2), and the Reynolds Adolescent Depression Scale, Second Edition (RADS–2). [b] The CIS collects data on the status of the child/family in the 6 months prior to the interview. The RCMAS-2 and the RADS–2 measure problems at the time of the interview and are administered to youth 11 years and above. [c] Shaded cells indicate that no score ranges are applicable to these subscales.



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Percent Scoring in the Clinical Range[a] of Impairment, Anxiety, and Depression at Intake and 6 Months

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CIS Total Impairment (n = 50) 90.0% 82.0%

RCMAS Total Anxiety (n = 36) 30.6% 22.2%

RADS Total Depression (n = 37) 16.2% 24.3%

Intake 6 Months

[a] A score of 15 or higher is considered clinically impaired on the Columbia Impairment Scale (CIS). A total T-score greater than 60 indicates a high level of impairment on the Revised Children’s Manifest Anxiety Scale, Second Edition (RCMAS-2). A score of 61 or higher on the Reynolds Adolescent Depression Scale–Second Edition (RADS–2) indicates a clinical level of depression. The CIS collects data on the status of the child/family in the 6 months prior to the interview. The RCMAS-2 and RADS–2 measure problems at the time of the interview.



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Reliable Change Index[a] of Impairment, Anxiety, and Depression from Intake to 6 Months

4.0%8.3% 8.1%

80.0% 72.2%

86.5%

16.0%19.4%

5.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CIS Total Impairment

(n = 50)

RCMAS Total Anxiety

(n = 36)

RADS–2 Total Depression

(n = 37)

Subscale

Worsened Remained Stable Improved

[a] The Reliable Change Index (RCI) is a relative measure that compares a child's or caregiver's scores at two different points in time and indicates whether a change in score shows significant improvement, worsening, or stability (i.e., no significant change).



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Reliable Change Index[a] of Reynold’s Adolescent Depression Scale (RADS-2) from Intake to 6 Months

10.8%

2.7%8.1%

2.7%

78.4% 94.6% 83.8% 94.6%

10.8%

2.7%8.1%

2.7%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Dysphoric Mood

(n = 37)

Anhedonia

(n = 37)

Negative Self-Evaluation

(n = 37)

Somatic Complaints

(n = 37)

Measure[b]


[a] The Reliable Change Index (RCI) is a relative measure that compares a child's or caregiver's scores at two different points in time and indicates whether a change in score shows significant improvement, worsening, or stability (i.e., no significant change). [b] Data reported were collected using Columbia Impairment Scale (CIS). This instrument collects data on the status of the child/family in the 6 months prior to the interview. The Revised Children’s Manifest Anxiety Scale (RCMAS), and Reynolds Adolescent Depression Scale–Second Edition (RADS–2) measure problems at the time of the interview.



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Child Competence and Behavioral and Emotional Problems[a] at Intake

Measure CBCL 6–18 Average Score

Clinical Range

Competence

Social 35.2 (n = 95) <30.0

Activities 36.6 (n = 98) <30.0

School 35.8 (n = 84) <30.0

Total Competence 30.5 (n = 78) <37.0

Behavioral and Emotional Problems

Social Problems 67.8 (n = 100) >=70.0

Thought Problems 69.9 (n = 100) >=70.0

Rule Breaking Behavior 67.1 (n = 100) >=70.0

Withdrawn 68.4 (n = 100) >=70.0

Somatic Complaints 62.9 (n = 100) >=70.0

Anxious/Depressed 67.3 (n = 100) >=70.0

Attention Problems 68.8 (n = 100) >=70.0

Aggressive Problems 71.9 (n = 100) >=70.0

Internalizing Problems 67.4 (n = 100) >63.0

Externalizing Problems 69.4 (n = 100) >63.0

Total Problems 70.5 (n = 100) >63.0

[a] The Child Behavior Checklist (CBCL) collects data on the status of the child/family in the 6 months prior to the interview.



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Percent Scoring in Clinical Range of Child Behavioral and Emotional Problems[a] for Children Ages 6 to 18 at

Intake and 6 Months

Internalizing and Externalizing

Scores[b]

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Data Collection Points

Avera

ge C

BC

L P

rob

lem

Sco

res

Internalizing

Behaviors

64.0% 68.0%

Externalizing

Behaviors

86.0% 80.0%

Intake 6 Months

n = 50

Eight Syndrome Scale Scores[b]

Intake

6 Months

Withdrawn 38.0% 38.0%

Somatic Complaints

30.0% 28.0%

Anxious/

Depressed

42.0% 44.0%

Social Problems

54.0% 44.0%

Thought Problems

60.0% 48.0%

Attention Problems

40.0% 46.0%

Rule Break Behaviors

58.0% 42.0%

Aggressive Behavior

70.0% 64.0%

[a] Data reported were collected using the Child Behavioral Checklist 6–18 (CBCL 6–18). This instrument collects data on the status of the child/family in the 6 months prior to the interview. [b] Internalizing and externalizing scores 64 or above are in the clinical range. Scores on the eight syndrome scales 70 or above are in the clinical range.



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Average Child Competence Scores[a] for Children Ages 6 to 18 Years at Intake and 6 Months

20

25

30

35

40

45

50

55

60

65

Data Collection Points

Avera

ge C

BC

L 6

–1

8 C

om

pete

nce S

co

res[b

]

Activities (n = 48) 40.6 39.7

Social (n = 49) 36.1 35.8

School (n = 37) 35.0 38.1

Intake 6 Months

[a] Data reported were collected using the Child Behavioral Checklist 6–18 (CBCL 6–18). This instrument collects data on the status of the child/family in the 6 months prior to the interview. [b] Scores under 30 are in the clinical range (i.e., less competent).



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Reliable Change Index[a] of Child Behavioral and Emotional Problems in Children Ages 6 to 18 Years[b]

from Intake to 6 Months

10.0% 10.0%

78.0%

70.0%

12.0%

20.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Internalizing Problems

(n = 50)

Externalizing Problems

(n = 50)

Subscale


[a] The Reliable Change Index (RCI) is a relative measure that compares a child's or caregiver's scores at two different points in time and indicates whether a change in score shows significant improvement, worsening, or stability (i.e., no significant change). [b] Data reported were collected using the Child Behavioral Checklist 6–18 (CBCL 6–18). This instrument collects data on the status of the child/family in the 6 months prior to the interview.



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Caregiver and Youth Report of Behavioral and Emotional Strengths[a] at Intake

Strength Subscale[b]

BERS–2C Average Score

BERS–2C

n

BERS–2Y Average Score

BERS–2Y

n

Interpersonal Strength

6.1 101 9.8 67

Family Involvement

6.0 101 9.0 67

Intrapersonal Strength

6.3 101 10.3 67

School Functioning

5.8 101 9.1 66

Affective Strength

7.3 101 10.6 67

Career Strength

8.5 99 10.5 66

Strength Index[c]

74.7 101 97.9 66

[a] Data reported were collected using the Behavioral and Emotional Rating Scale–Second Edition, Parent Rating Scale (BERS–2C) and the Behavioral and Emotional Rating Scale–Second Edition, Youth Rating Scale (BERS–2Y). This instrument collects data on the status of the child/family in the 6 months prior to the interview. [b] Strength subscales on the BERS–2C range from 1 to 16, and on the BERS–2Y from 1 to 18. Average scores on both instruments range between 8 and 12. Higher scores indicate greater strength. [c] Strength Indexes for both BERS–2C and BERS–2Y range from 38 to 161, with an average index between 90 and 110. A higher index indicates greater overall strengths.



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Caregiver Report of Behavioral and Emotional Strengths[a] at Intake and 6 Months


BERS–2 Caregiver Average Score

Intake 6 Months


(n = 50)

5.4 6.1

Family Involvement

(n = 50)

5.7 5.9


(n = 50)

6.4 6.9

School Functioning

(n = 49)

5.5 5.8

Affective Strength

(n = 50)

7.4 7.5

Career Strength

(n = 50)

8.6 9.3

Strength Index[c]

(n = 49)

73.0 75.4

[a] Data reported were collected using the Behavioral and Emotional Rating Scale–Second Edition, Parent Rating Scale (BERS–2C). This instrument collects data on the status of the child/family in the 6 months prior to the interview. [b] Strength subscales on the BERS–2C range from 1 to 16 with an average score between 8 and 12. Higher scores indicate greater strength. [c] Strength Index on the BERS–2C ranges from 38 to 161 with an average index between 90 and 110. A higher index indicates greater overall strengths.



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Reliable Change Index[a] for Caregiver Report of Behavioral and Emotional Strengths[b] from Intake to 6

Months

6.0%2.0% 4.0%

10.2%6.0% 4.0%

76.0%

98.0% 92.0%75.5% 86.0%

82.0%

18.0%

0.0%4.0%

14.3%8.0%

14.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Interpersonal

Strength

(n = 50)

Family Involvement

(n = 50)

Intrapersonal

Strength

(n = 50)

School Functioning

(n = 49)

Affective Strength

(n = 50)

Career Strength

(n = 50)

Strength Subscale


[a] The Reliable Change Index (RCI) is a relative measure that compares a child's or caregiver's scores at two different points in time and indicates whether a change in score shows significant improvement, worsening, or stability (i.e., no significant change). [b] Data reported were collected using the Behavioral and Emotional Rating Scale–Second Edition, Parent Rating Scale (BERS–2C). This instrument collects data on the status of the child/family in the 6 months prior to the interview.



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Youth Report of Behavioral and Emotional Strengths[a] at Intake and 6 Months


BERS–2 Youth Average Score

Intake 6 Months


(n = 37)

9.3 9.4

Family Involvement

(n = 37)

8.9 8.8


(n = 37)

10.8 10.4

School Functioning

(n = 37)

9.1 9.1

Affective Strength

(n = 37)

11.0 11.2

Career Strength

(n = 37)

10.6 10.7

Strength Index[c]

(n = 37)

98.3 98.4

[a] Data reported were collected using the Behavioral and Emotional Rating Scale–Second Edition, Youth Rating Scale (BERS–2Y). This instrument collects data on the status of the child/family in the 6 months prior to the interview. [b] Strength subscales on the BERS–2Y range from 1 to 18 with an average score between 8 and 12. Higher scores indicate greater strength. [c] Strength Index on the BERS–2Y ranges from 38 to 161 with an average index between 90 and 110. A higher index indicates greater overall strengths.



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Reliable Change Index[a] for Youth Report of Behavioral and Emotional Strengths[b] from Intake to 6 Months

8.1% 5.4% 2.7% 5.4%0.0%

5.4%

81.1% 89.2% 94.6% 91.9% 100.0%94.6%

10.8%5.4% 2.7% 2.7% 0.0% 0.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Interpersonal

Strength

(n = 37)

Family Involvement

(n = 37)

Intrapersonal

Strength

(n = 37)

School Functioning

(n = 37)

Affective Strength

(n = 37)

Career Strength

(n = 37)

Strength Subscale


[a] The Reliable Change Index (RCI) is a relative measure that compares a child's or caregiver's scores at two different points in time and indicates whether a change in score shows significant improvement, worsening, or stability (i.e., no significant change). [b] Data reported were collected using the Behavioral and Emotional Rating Scale–Second Edition, Youth Rating Scale (BERS–2Y). This instrument collects data on the status of the child/family in the 6 months prior to the interview.



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Reliable Change Index[a] for the Caregiver and Youth Strength Index[b] from Intake to 6 Months

16.3%

8.1%

53.1%

81.1%

30.6%

10.8%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Caregiver

(n = 49)

Youth

(n = 37)

Strength Index


[a] The Reliable Change Index (RCI) is a relative measure that compares a child's or caregiver's scores at two different points in time and indicates whether a change in score shows significant improvement, worsening, or stability (i.e., no significant change). [b] Data reported were collected using the Behavioral and Emotional Rating Scale–Second Edition, Parent Rating Scale (BERS–2C) and the Behavioral and Emotional Rating Scale–Second Edition, Youth Rating Scale (BERS–2Y). This instrument collects data on the status of the child/family in the 6 months prior to the interview.

What is the DPR?

• The Data Profile Report (DPR) is prepared by the National Evaluation

Team three times a year (April, August, December)

• It reports on all youth who have been served by the System of Care, in

any capacity.

– That’s 390 youth at the time of this report (August, 2011).

• It also reports on the sample of caregivers and youth enrolled in the

longitudinal outcome study.

– That is 104 caregivers and 68 youth at the time of this report. Enrollment is

continuing.

– We have enough data now to start looking at trends from the baseline

interview (within 30 days of SOC enrollment) to the 6-month interview.

• So far, 54 caregivers and 37 youth have completed both the baseline and 6-

month interviews. Interviews are continuing. (See last slide for Number Table)

New York (Orange County) Data Profile Report April 2011

Data are from the CMHS National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program. This report is based on data submitted through April 11, 2011. DO NOT DISTRIBUTE

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How Do We Get the Information for this Report?

Caregivers and youth enrolled in the study are interviewed within 30 days of intake into the system of care and every 6 months for 24 months (a total of 5 interviews). We use the questionnaires (or “instruments”) listed below:

Caregiver Youth (11 years and older)

• Enrollment and Demographic Information Form (EDIF)

• Caregiver Information Questionnaire, Revised (CIQ–R)

• Youth Information Questionnaire, Revised (YIQ-R)

• Living Situations Questionnaire (LSQ)

•Child Behavior Checklist 6 to 18 (CBCL 6–18) • Revised Children’s Manifest Anxiety Scale (RCMAS), 2nd edition (RCMAS–2)

• Reynold’s Adolescent Depression Scale (RADS–2)

• Columbia Impairment Scale (CIS)

• Education Questionnaire–Revision 2 (EQ–R2)

• Substance Use Survey–Revised (SUS–R)

• GAIN Quick–R: Substance Problem Scale (GAIN)

• Delinquency Survey–Revised (DS–R)

•Behavioral and Emotional Rating Scale (BERS–2C) • Behavioral and Emotional Rating Scale (BERS–2Y)

•Parenting Stress Index (PSI)

•Caregiver Strain Questionnaire (CGSQ)

• Multi-Sector Service Contacts (MSSC–R)

• Cultural Competence and Service Provision (CCSP) Questionnaire

• Youth Services Survey (YSS)

• Preschool Behavioral and Emotional Rating Scale (PreBERS)

• Devereux Early Childhood Assessment (DECA –C)

•Youth Services Survey for Families (YSS–F)



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Some Important Explanations Before You Continue…

● The time period for intake, or “baseline”, questions is the 6-month period just prior to the interview date. This is a different date for each respondent depending on when they are enrolled in the study. So, a baseline date for one family could be May 14, 2010 and for another family it could be February 2, 2011. ● The number of cases reported in each slide varies, depending on the data available and

what the data source is. Some data are reported on all youth served and some are reported on the sample of youth and families enrolled in the longitudinal study. Be sure to take note of the data source and “n” on each slide. ● Summary statistics based on fewer than 10 cases are not reported. When all summary statistics on a slide are based on fewer than 10 cases, the entire slide is not included. ● When data for follow-up timeframes are reported, the number of cases reported include only cases with complete follow-up data for all timeframes. That is, only those respondents who have both baseline and 6-month interviews completed. ● When the number of cases reporting data for a timeframe is less than 30, that

timeframe is not included.



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Number Table (aka – how many people have responded to each

questionnaire at each interview interval?)

BERS–2C BERS–2Y CBCL–O CBCL–Y CCSP CGSQ CIQ CIS DS–R EDIF[a] EQ–R PSI GAIN LSQ MSSC–R RADS–2 RCMAS SUS–R PreBERS DECA-I DECA-T DECA-C YIQ YSS–F YSS–Y

intake 101 68 101 0 93 100 101 68 390 103 38 68 104 104 68 68 68 0 0 0 0 66

6 Month 50 40 50 0 53 49 50 50 40 55 54 19 40 54 54 40 40 40 0 0 0 0 40 49 40

12 Month 28 23 28 0 27 25 28 28 23 30 30 11 23 30 30 23 23 23 0 0 0 0 23 25 23

18 Month 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

24 Month 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

BERS–2C BERS–2Y CBCL–O CBCL–Y CCSP CGSQ CIQ CIS DS–R EDIF[a] EQ–R PSI GAIN LSQ MSSC–R RADS–2 RCMAS SUS–R PreBERS DECA-I DECA-T DECA-C YIQ YSS–F YSS–Y

int + 6 Month 50 37 50 0 48 50 50 37 55 53 18 37 54 54 37 37 37 0 0 0 0 37

int + 12 Month 28 18 28 0 25 28 28 18 30 30 11 18 30 30 18 18 18 0 0 0 0 18

int + 18 Month 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

int + 24 Month 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

int+6m+12m 26 16 26 0 23 26 26 16 28 28 10 16 28 28 16 16 16 0 0 0 0 16

int+6m+12m+18m 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

int+6m+12m+18m+24m 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

[a] The CIUF is considered to be the follow-up instrument to the EDIF, so they are presented together.



23

Disclaimer

Site-specific Data Profile Reports (DPRs) are designed for use by local communities, the national evaluation team, and program partners. Members of the national evaluation team and program partner organizations should not distribute these reports to others outside of their organization or use the reports for purposes other than technical assistance. Only the grant communities themselves and the Child, Adolescent, and Family Branch of the Center for Mental Health Services can approve the sharing of site-level information. In addition, grant communities must provide their express permission for sharing of site-specific information. The views expressed in written conference materials or publications and by speakers and moderators at HHS-sponsored conferences, do not necessarily reflect the official policies of the Department of Health and Human Services, nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Documents

Section VI: Clinical Measures National Evaluation of the