Behavioral Health Partnership Oversight Council

Quality Management & Access Subcommittee

Legislative Office Building Room 3000, Hartford CT 06106

(860) 240-0321 Info Line (860) 240-8329 FAX (860) 240-5306
www.cga.ct.gov/ph/medicaid
 

Meeting Summary: January 6, 2006

The QM & A Committee of the BHP Oversight Council met on 01/06/2005 from 13:00 to 16:00 in room 3800 of the LOB to review the Enhanced Care Clinic Proposal draft of 12/14/2005 and the Connecticut Community Providers Association Recommendations Regarding the “Access to Care” Requirement Under the Enhanced Care Clinic Model of 11/17/2005 submitted to the BHP Oversight Council by the Departments and the CCAP respectively for consideration.

The QM & A Committee of the BHP Oversight Council will meet on 01/20/2005 13:00 to 16:00 in the conference room of the Rushford Center in Meriden to continue its work to complete the BHP web-based outpatient service registration form for Husky A and B enrollees and to refine the HSRI indicator set that will be implemented to track ASO performance and to determine an implementation schedule. An agenda will be forwarded under separate cover.

Many of the QM & A Committee's conclusions and recommendations have paralleled those of the Provider Advisory Committee reached at its meeting of 01/06/2006 and 01/11/2005 and the Provider Advisory Committee will submit recommendations jointly for both Committees.

The QM & A Committee agreed that the ASO in collaboration with the Departments develop protocol/guidelines to facilitate uniform rapid screening and triage of client walk-ins and phone-ins into three classes: emergent, urgent, and routine. (Although members expressed uncertainty about the validity and utility of the “urgent” category, it was felt important to retain the category at least as a place holder for future research.)

The Committee concurred that screening should occur within 2 hours of walk-in or initial phone contact and, when indicated (i.e. for emergent cases), crisis assessment should follow within the same time frame. Offered and follow up appointments should accord to the time frames proposed in the Provider Advisory Group Preliminary Enhanced Care Clinic Recommendations. It believed that that access thresholds (set at 95% in the draft proposal from the Departments) could not currently be set, but should be determined from analysis of data generated in the early months of the operation of the BHP.

Considerable discussion was devoted the complicated conceptual and measurement issues that must be resolved to permit accurate determination of access thresholds and monitor improvements in access (to whatever benchmark is finally determined). ASO and Department staffs will develop suitable data plans to achieve these aims and submit these for review to the Committee and final revisions in the BHP web-based outpatient service registration form will be made with these considerations in mind.

The Committee believed, as well, that the Departments needed to provide better data to support the contention that the proposed 25% increase in rates would permit the infrastructural and personnel changes that would allow clinics to achieve the 20% increase in access required of a clinic to qualify for ECC status.

Clearer and more fully adumbrated guidelines for implementation of coordination of care, evidence-based practices, co-occurring capable and clinical specialization would be of help to clinics seeking ECC status. Many of the same methodological issues apply to the challenge of setting an appropriate benchmark for COD screening and management as for timely triage, referral and follow up of patients presenting for screening at walk-in or phone-in.

Moreover, it seemed possible that differences in regional and other factors might necessitate establishing different benchmarks for different clinics. Although the hope that benchmarking could be made as fair and valid as possible without resorting to such stratification, the necessity could not be eliminated.

In summary: The QM & A Committee believes that more work is required to refine and anchor the EEC requirements. It believes that the PAC has defined the major issues and provided useful recommendations and suggestions. It concurs with the recommendations of the PAC.