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 20, 2006
Acting Chair 1/20/06: Paula Armbruster
Next meeting: Friday Feb. 24, 2006 from 9-11 AM @ Rushford, Meriden)
Attendees: R.Adams (DMHAS), P. Armbruster (Vice-Chair), M. Schaefer & T.Creel (DSS), T. Ines & A. Hart (VOI), E. Luchansky (CGC), V. Mulkern (HSRI), S. Niemitz (Hart. BH), S. O'Connell (Village), A. Pritchard & A. Kamm (DCF),
L. Russo (Wheeler Clinic), M.M.Court (Leg. staff).
Performance Indicators (please click on the icon below for the working list developed by HSRI that was used by the subcommittee at this meeting).
Dr. Virginia Mulkern, Health Service Research Institute (HSRI), responsible for developing the CT BHP program performance indicators under a federal grant to DSS, reviewed the categories, issues to date. The Subcommittee discussed the conceptual and operational aspects of noted issues/options of the categories and reached the following consensus for the identified categories:
• Access #1 (see above document for explanation of the # items): Through work with the Provider Advisory SC on the Enhanced Care Clinics (ECC), Dr. Schaefer (DSS) is developing a work flow process that will help define how to capture emergent access on the registration screen.
• Access #4a: Urgent Medical evaluation (I.E. post hospital discharge) would be flagged in the registration screen.
• Access #4b: When the client clinical evaluation concludes that a medical (medication) evaluation is needed, this determination would “start the clock” on securing said evaluation.
• Access #5: This measure conceptually looks to assess psychiatric prescribing provider availability (density) within geographic areas (using the DCF 15 regions) versus timely access to such services. Consensus:
o Limit psychiatric medication “prescribing practitioner” to non-pediatric providers.
o Measurement would include the number of scripts by provider in a given geographic area.
o Comparison data could come through a cross-walk of HUSKY pharmacy data base. DSS will look at what the Pharmacy Benefits Managers (PBM) data includes.
o The ASO will work with DSS to see how PBM record, already integrated in the DSS data warehouse, would help answer the question regarding those identified as needing a medication evaluation and those that did not receive the evaluation.
• Coordination of BH and medical care #17,18 &19: these measures present a challenge in operationalizing (I.E. identifying number of complex needs children receiving HUSKY MCO and ASO case management and evidence of coordination). Consensus :
o Use as a starting point the number of cases per 1000 MCO members and ASO numbers.
o Then identify the demographics of these members (I.E. diagnoses, case management)
o Define how to measure the bi-weekly care coordination meetings between the MCO & ASO.
o At the next meeting, have the ASO report on the tiers/levels of CM and tracking process.
o # 18 is a subset of #19; therefore it may be possible to identify through the registration screen the percentage of primary care notifications for BH services and the Axis 3 diagnoses recorded. This data can be refined to meat the goals of the measure. For example Mercer could do a limited field study to provide information on medical and/or psychiatric “high-risk” clients.
• Community tenure #29 & foster children's stability in community placement #29A: community tenure is population-based, looking at non-hospital days in the community. Consensus:
o Measure the number of admissions to hospital, RTC, PRTF, length of stay and number of children/youth.
o # 29a remains as defined.
• High Utilizers # 30: Concept of the measure is to capture those members receiving the appropriate levels of care. The definition of “high utilizers” is pending.
o The ASO was asked to bring their Intensive Care Management (ICM) criteria to the next meeting, as the criteria may help better define this term and develop an operational context.
o At the next meeting the SC could look at the care patterns that emerge (I.E. ED/hospital admission for a given time period). May need to reserve further definition of this measure when data is available.
The Feb. 24th meeting topics will include:
• ASO: tiers/levels of case management and ICM criteria.
• If DSS can review PBM data prior to the meeting, the SC could look at Access # 5 again regarding medication evaluations.
• Review current status of VOI registration screen content.
• ECC: adult timeliness of care.