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DocuSign Envelope ID:CAABEAFA-9919-4207-B5CD-58E618EA747E <br /> QSR STATUS & PRACTICES MEASURES AND THEIR USES <br /> 3. PHYSICAL HEALTH STATUS.Degree to which the person is: • Achieving peer support and community activities. • The person has opportunities to <br /> and maintaining favorable health status,given any disease diagnosis and prog- meet people outside of the service provider organization and to spend time <br /> nosis that the person may have; and • Receiving adequate and consistent with them. • The person's social network supports recovery efforts. This <br /> levels of health care appropriate for the person's age, personal needs, and indicator may not apply to persons under5 years of age. <br /> preferences.This indicator applies to all persons. <br /> 12a. EARLY LEARNING STATUS.Degree to which: •The child's developmental <br /> 4. EMOTIONAL/MENTAL HEALTH STATUS: Consistent with age and ability, status is commensurate with age and developmental capacities. •The child's <br /> degree to which the person is displaying an adequate pattern of: • Presenting developmental status in key domains is consistent with age- and ability- <br /> an affect regulation appropriate to person and situation; • Managing clinical appropriate expectations.This indicator applies to persons under5 years. <br /> symptoms of emotional/behavioral/thought disorders that interfere with daily <br /> activities; • Socializing and connecting with others; and, • Participating in 12b. ACADEMIC STATUS.Degree to which: • The child or youth[according to age <br /> major activities and decisions affecting the person's life.This indicator may and ability]is:(1)regularly attending school,(2)placed in a grade level consistent <br /> not apply to persons under 3 years of age. with age or developmental level,(3)actively engaged in instructional activities,(4) <br /> reading at grade level or IEP expectation level,and(5)meeting requirements for <br /> 5. SUBSTANCE USE STATUS. Degree to which the person is achieving and annual promotion and course completion leading to a high school diploma,a GED, <br /> maintaining a life free from substance use impairment.This indicator may not or preparation for employment.This indicator applies to a school age child or <br /> apply to persons under 8 years of age. youth who is 5 years of age or older. <br /> 6. SPIRITUAL WELL-BEING. Degree to which: • The person has a positive 12c. PREPARATION FOR ADULTHOOD.Degree to which the youth[according to <br /> guiding force for purpose and direction in life; •The person relies on positive age and ability]is: • Gaining life skills,developing relationships and connec- <br /> spiritual beliefs and supports to provide comfort and encouragement in times tions,and building capacities for living safely,becoming gainfully employed, <br /> of difficulty, despair, and challenge,while bringing hope and faith to seem- and functioning successfully upon becoming independent of child services- <br /> ingly hopelessness situations; • In times of stress and worry,the person has OR- • Becoming eligible for adult services and with the adult system being <br /> positive sources for spiritual strength and emotional protection that enable ready to provide(via a seamless transition)continuing care,treatment,and <br /> the person to cope with fear,guilt,shame,loss,and gain courage to meet life residential services that the youth will require upon discharge from services. <br /> challenges; • The person belongs to and participates in group activities that This indicator applies to a youth 15 years to 18 years of age. <br /> support spiritual growth and well-being of members.This indicator may not <br /> apply to persons under 12 years of age, 12d. EDUCATION/CAREER DEVELOPMENT. Degree to which the person <br /> (adult): • Is actively engaged in educational activities(e.g.,adult basic educa- <br /> 7. FUNCTIONAL STATUS. Degree to which the person, based on need and tion, GED course work, or post-secondary education), vocational training <br /> choice,is actively acquiring and/or using acquired functional life skills necessary programs,or transitional employment. • Is receiving information about work <br /> for successful daily living.This indicator applies to persons over age 3. benefits, access to work supports, rights,responsibilities,and advocacy. This <br /> indicator applies to adults. <br /> 8. VOICE & CHOICE / SELF-DIRECTED CARE. Degree to which: • The <br /> person is an active ongoing participant(e.g.,having a significant role;voice, 13. WORK STATUS.As appropriate to life stage,functional status,and personal <br /> and influence)in decisions made about wellness and recovery goals,interven- preference,the degree to which the person is: •Actively engaging in employ- <br /> tion strategies,services,and results; • For a willing and able adult,the person ment,competitive or supported(earning federal minimum wage or above,in an <br /> is actively directing some or all aspects of the care being provided.This indi- integrated community setting),or in an individual placement with supports in a <br /> cator may not apply to persons under 12 years of age, productive situation. • [If presently limited by labor market opportunities or a <br /> disabling condition] The person is exploring or engaged in productive volun- <br /> 9. ECONOMIC SECURITY&PERSONAL MANAGEMENT.Degree to which: teer opportunities in consumer-operated services, a community center, or a <br /> •The person's earned income and economic supports are sufficient to cover library.This indicator applies to adults. <br /> basic living requirements (i.e.,shelter,food, clothing, transportation, health <br /> care/medicine,leisure,childcare). • The person is accessing,receiving,and 14. PARENT&CAREGIVER FUNCTIONING.Degree to which: • The person <br /> managing the economic benefits for which he/she is eligible. • The person functions as an adequate parent for dependent children and/or a caregiver for <br /> has economic security sufficient for maintaining stability and for sustaining the a dependent adult for whom the person has caregiving responsibilities. •The <br /> ability to meet ongoing life needs.This indicator applies to adults. person is willing and able to provide the child or dependent adult with the <br /> care,assistance,protection,guidance,supervision,and support necessary for <br /> 10. LIVING SITUATION.Degree to which: •APPROPRIATENESS.The person daily living,child development,or necessary adult care.This indicator applies <br /> is living in the most appropriate and least restrictive living arrangement that is to persons who care for dependent children or adults in the person's home. <br /> consistent with his/her physical and emotional needs,language and culture, <br /> life stage, ability level, and support for recovery. • STABILITY. The living 15. RECOVERY ACTION STATUS. Degree to which the person: • Is actively <br /> arrangement is consistent with the person's preference, enduring and free engaged in activities necessary to achieve and maintain freedom from substance <br /> from disruption,and provides continuity in daily routines,normal rhythms of use impairment, reduce psychiatric symptoms, improve health, and increase <br /> life,and relationships supportive of recovery.This indicator may not apply to competencies, coping, self-management, social integration, and ongoing <br /> persons in secure confinement. recovery. • [if not engaged in wellness and recovery efforts,the degree to <br /> which the person] Has access to wellness, recovery, and relapse prevention <br /> 11. SOCIAL SUPPORTS. Degree to which: • The person is connected to a opportunities, subject to his/her needs, life ambitions, and personal prefer- <br /> meaningful and supportive network of family,friends, and peers, consistent ences.This indicator applies to persons who are working on recovery. <br /> with his/her choices and preferences. • The person has access to positive <br /> QSR INSTITUTE, CWPPG, 2016 0 PAGE 2 <br />