CalEQRO FY18-19 Tools Update Tuesday, July 24, 2018 Behavioral - - PowerPoint PPT Presentation

Behavioral Health Concepts, Inc.

CalEQRO FY18-19 Tools Update

Tuesday, July 24, 2018

Behavioral Health Concepts, Inc.

How to submit your questions

• Please use the chat line.

Meet the Team

Quality Reviewers

Information Systems Reviewers Consumer/ Family Member Consultants*

Admin/ Operations

*CalEQRO acknowledges the contributions of other Consumer/Family Member Consultants who work with us on reviews

Saumitra SenGupta Gale Berkowitz Della Dash Cyndi Lancaster Lynda Hutchens Ewurama Shaw-Taylor Rob Walton Laysha Ostrow Harriet Markell Rama Khalsa Tom Trabin Maureen Bauman Michael Hutchinson Melissa Martin-Mollard Patrick Zarate Bill Ullom Lisa Farrell Duane Henderson Lisa Farrell Judy Toomasson Bob Greenless Marilyn Hillerman Tilda DeWolfe Walter Shwe Deb Strong Mei Chung Kimberlee Cathey Rachel Phillips Desmond Kispert-Bostick

Behavioral Health Concepts, Inc.

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
• Consumer Family Member Focus Group(s)

= new in FY18-19 = 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
• Site Visit to Innovative Clinical Programs

= new in FY18-19 = modified for FY18-19

Behavioral Health Concepts, Inc.

List of Review Tools

Timeliness Self-Assessment ISCA Katie A. PIP Roadmap Focus Group Guides Key Components Performance Measures PIP Validation Tool Report Template

Pre-Site On-Site Post-Site

= 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) ISCA/Billing/Fiscal Prescriber/Medication Supported Employment Timeliness Self-Assessment ISCA Katie A. Key Components Performance Measures Report Template

Sessions Tools

= new in FY18-19 = modified for FY18-19

Behavioral Health Concepts, Inc.

• The number of Medi-Cal eligible minor and non-minor dependents.
• 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,

• utpatient 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. Source: EPSDT POS Dashboard

New Performance Measures – SB 1291

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 related to psychotropic medications, including, but not limited to, the 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). Source: CDSS-DHCS Child Welfare Psychotropic Medication Measures

Behavioral Health Concepts, Inc.

New Performance Measures – SB 1291 (Contd.)

• 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.

Source: Existing EQRO Protocols and Activities

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:

• 5A (1&2) Use of Psychotropic Medications
• 5C Use of Multiple Concurrent Psychotropic Medications
• 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. Data: ☐ Entire System ☐ County Operated Only ☐ Contract Providers Only All Services Adult Services Children’s Services Foster Care Average length of time from first request for service to first clinical assessment

days (mean) days (median)

• Std. Dev.

days (mean) days (median)

• Std. Dev.

days (mean) days (median)

• Std. Dev.

days (mean) days (median)

• 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)

• 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
• f 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?

Significant Change – Addition of questions on Therapeutic Foster Care (TFC)

Behavioral Health Concepts, Inc.

ISCA

• Significant Change -
• BHC will support 3 versions of ISCA tool for FY1819 reviews to address unique IT
• perations and Medi-Cal billing conditions between MHPs and DMC-ODS programs.
• Summary of ISCA versions:
• MHP standalone reviews
• will apply to more than 50 reviews
• DMC-ODS standalone reviews - will apply to most (12-15) reviews
• 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.

New Sessions

• Prescribers and Medications
• There is increased attention from CMS on National Quality Forum endorsed

medication related HEDIS measures. In FY18-19, CalEQRO will determine and MHP capabilities, strengths, and challenges.

• Supported Employment and/or Other Employment Supports
• These sessions will assess the MHP efforts to support consumer employment and

education for recovery, independence, and engagement in society.

• For both, standalone sessions where feasible.
• Otherwise, some key questions incorporated in other sessions, as appropriate.

Behavioral Health Concepts, Inc.

Key Components

• No changes at the key component level.
• Minor changes in the sub-components that are used to determine the ratings for

each key component.

• Review the revised tool here.

Behavioral Health Concepts, Inc.

Report Template

• No more summaries in the beginning of the report.
• The report will start with the existing introduction.
• Performance measures will include the SB 1291 items that can be obtained from the

EPSDT POS dashboards and CDSS-DHCS child welfare psychotropic medications measures.

• No more impacts and implications at the end of each report section.
• Section order slightly changed. Key components will now come after the

consumer/family member focus group summaries.

• Recommendations will be made more concise and specific. Those with multiple

steps or issues will now be broken into individual recommendations for better determination of status the following year. This could result in higher number of recommendations.

Behavioral Health Concepts, Inc.

Questions?

info@bhceqro.com

Behavioral Health Concepts, Inc.

www.caleqro.com