CalEQRO FY18-19 Tools Update Tuesday, July 24, 2018 Behavioral Health Concepts, Inc.
How to submit your questions Please use the chat line. • Behavioral Health Concepts, Inc.
Meet the Team Della Dash Cyndi Lancaster Lynda Hutchens Ewurama Shaw-Taylor Harriet Markell Saumitra SenGupta Gale Berkowitz Rob Walton Laysha Ostrow Quality Reviewers Rama Khalsa Tom Trabin Maureen Bauman Michael Hutchinson Patrick Zarate Melissa Martin-Mollard Judy Toomasson Bill Ullom Lisa Farrell Lisa Farrell Duane Henderson Bob Greenless Information Systems Reviewers Marilyn Hillerman Tilda DeWolfe Walter Shwe Deb Strong Consumer/ *CalEQRO acknowledges the contributions of other Family Consumer/Family Member Consultants who work Member with us on reviews Consultants* Mei Chung Kimberlee Cathey Rachel Phillips Desmond Kispert-Bostick Admin/ Operations
What’s New for FY18-19 Senate Bill 1291 (Mental Health Services for Foster Children and Youth) • Assembly Bill 1299 (Presumptive Transfer) • Assembly Bill 205 (Network Adequacy) • Drug Medi-Cal EQRO • Behavioral Health Concepts, Inc.
List of Review Sessions Opening Session • Use of Data to Support Program Operations • Disparities and Performance Measures/Timeliness Performance Measures • Quality Improvement and Outcomes • Performance Improvement Projects • Primary and Specialty Care Collaboration and Integration • Acute Care Collaboration and Integration • Health Plan and Mental Health Plan Collaboration Initiatives • Clinical Line Staff Group Interview • Clinical Supervisors Group Interview • Program Managers Group Interview • Consumer Employee Group Interview • = new in FY18-19 Consumer Family Member Focus Group(s) • = modified for FY18-19 Behavioral Health Concepts, Inc.
List of Review Sessions (continued) Contract Provider Group Interview – Administration and Operations • Contract Provider Group Interview – Quality Management • Community-Based Services Agencies Group Interview • Validation of Findings for Pathways to Mental Health Services (Katie A./CCR) • ISCA/Billing/Fiscal • EHR Deployment • Tele Mental Health • Prescriber/Medication • Supported Employment • Access Call Center Site Visit • Wellness Center Site Visit • Contract Provider Site Visit = new in FY18-19 • Site Visit to Innovative Clinical Programs • = modified for FY18-19 Behavioral Health Concepts, Inc.
List of Review Tools Timeliness Self-Assessment ISCA Pre-Site Katie A. PIP Roadmap Focus Group Guides On-Site Key Components Performance Measures PIP Validation Tool Post-Site Report Template = new in FY18-19 = modified for FY18-19 Behavioral Health Concepts, Inc.
New and Changed Sessions and Tools Disparities and Performance Measures/Timeliness Performance Measures Validation of Findings for Pathways to Mental Health Services (Katie A./CCR) Sessions ISCA/Billing/Fiscal Prescriber/Medication Supported Employment Timeliness Self-Assessment ISCA Katie A. Tools Key Components Performance Measures = new in FY18-19 Report Template = modified for FY18-19 Behavioral Health Concepts, Inc.
New Performance Measures – SB 1291 The number of Medi-Cal eligible minor and non-minor dependents. • Source : EPSDT POS Dashboard Types of mental health services provided to children, including prevention • and treatment services. These types of services may include, but are not limited to, screenings, assessments, home-based mental health services, outpatient services, day treatment services or inpatient services, psychiatric hospitalizations, crisis interventions, case management, and psychotropic medication support services. Performance data for Medi-Cal eligible minor and non-minor dependents in • foster care. Utilization data for Medi-Cal eligible minor and non-minor dependents in • foster care. Behavioral Health Concepts, Inc.
New Performance Measures – SB 1291 (Contd.) Medication monitoring consistent with the child welfare psychotropic • medication measures developed by the State Department of Social Services and any Healthcare Effectiveness Data and Information Set (HEDIS) measures Psychotropic Medication Measures related to psychotropic medications, including, but not limited to, the Source : CDSS-DHCS Child Welfare following: Follow-Up Care for Children Prescribed Attention Deficit Hyperactivity • Disorder Medication (HEDIS ADD). Use of Multiple Concurrent Antipsychotics in Children and Adolescents • (HEDIS APC). Use of First-Line Psychosocial Care for Children and Adolescents on • Antipsychotics (HEDIS APP). Metabolic Monitoring for Children and Adolescents on Antipsychotics • (HEDIS APM). Behavioral Health Concepts, Inc.
New Performance Measures – SB 1291 (Contd.) Source : Existing EQRO Protocols and Activities Access to, and timeliness of, mental health services, as described • in Sections 1300.67.2, 1300.67.2.1, and 1300.67.2.2 of Title 28 of the California Code of Regulations and consistent with Section 438.206 of Title 42 of the Code of Federal Regulations, available to Medi-Cal eligible minor and non-minor dependents in foster care. Quality of mental health services available to Medi-Cal eligible • minor and non-minor dependents in foster care. Translation and interpretation services, consistent with Section • 438.10(c)(4) and (5) of Title 42 of the Code of Federal Regulations and Section 1810.410 of Title 9 of the California Code of Regulations, available to Medi-Cal eligible minor and non-minor dependents in foster care. Behavioral Health Concepts, Inc.
New Performance Measures – SB 1291 (Contd.) Public Information Links to Senate Bill (SB) 1291 Specific Data Requirements 1. EPSDT POS Data Dashboards http://www.dhcs.ca.gov/provgovpart/pos/Pages/Performance-Outcomes-System- Reports-and-Measures-Catalog.aspx 2. Psychotropic Medication and HEDIS Measures http://cssr.berkeley.edu/ucb_childwelfare/ReportDefault.aspx includes: o 5A (1&2) Use of Psychotropic Medications o 5C Use of Multiple Concurrent Psychotropic Medications o 5D Ongoing Metabolic Monitoring for Children on Antipsychotic Medications New Measure http://www.dhcs.ca.gov/dataandstats/Pages/Quality-of-Care-Measures-in-Foster- Care.aspx Behavioral Health Concepts, Inc.
Timeliness Self-Assessment Significant Change - For each timeliness metric, CalEQRO is asking for foster care • timeliness as a separate category from adult and children’s to fulfill SB 1291 requirements. Example: • 1. The length of time from initial request to first offered appointment: Use this text box to provide any specific methodological issues: Click or tap here to enter text. ☐ Entire System ☐ County Operated Only ☐ Contract Providers Only Data: All Adult Children’s Foster Care Services Services Services days (mean) days (mean) days (mean) days (mean) Average length of time from first request for service to first days (median) days (median) days (median) days (median) clinical assessment Std. Dev. Std. Dev. Std. Dev. Std. Dev. MHP standard or goal days days days days Percent of appointments that % % % % meet this standard Range days days days days Behavioral Health Concepts, Inc.
Pathways to MH Services (Katie A./CCR) Significant Change – Addition of questions on Therapeutic Foster Care (TFC) Have County MHP, Child Welfare, and Juvenile Probation partners collaboratively conducted an assessment to determine • readiness to implement TFC? Have they developed a TFC implementation plan? • Does the MHP intend to contract with a Foster Family Agency (FFA) to serve as the TFC Agency? • Are there plans underway that consider a different arrangement (i.e. to establish a county-owned and operated TFC • Agency)? Have MHP, Child Welfare, and Juvenile Probation partners engaged in discussions with an FFA(s) regarding the provision • of TFC? Has the MHP released a Request for Proposal to solicit FFAs interested in becoming a TFC Agency? • Have MHP, Child Welfare, and Juvenile Probation partners developed an estimate of how many TFC parents will be • needed in your county? If so, how many? • Describe the efforts the Child Welfare and Juvenile Probation partners are undertaking in the recruitment of • prospective foster parents who might be TFC Parents. What challenges are MHP, Child Welfare, and Juvenile Probation partners encountering regarding implementation of • TFC, and how is your county addressing these challenges? Behavioral Health Concepts, Inc.
ISCA Significant Change - • BHC will support 3 versions of ISCA tool for FY1819 reviews to address unique IT • operations and Medi-Cal billing conditions between MHPs and DMC-ODS programs. Summary of ISCA versions: • o MHP standalone reviews - will apply to more than 50 reviews o DMC-ODS standalone reviews - will apply to most (12-15) reviews o MHP/DMC-ODS joint reviews - handful (3-5) reviews Same/similar format requests for information (questions) between versions. • For joint reviews, where both MHP & DMC-ODS programs are on same/similar • timeframe, they can submit one ISCA tool that covers both IT operations and billing conditions to consolidate work efforts. Behavioral Health Concepts, Inc.
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