ACO Mapping Group RecommendationsACO Mapping Group Recommendations
1. Are the subclass members being identified?
2.Are the subclass members being assessed?
3.Are the subclass members receiving services?
4.Which services are they receiving?
5.Are the services they are receiving appropriate?
6.Are the services received improving outcomes?
Safety
Permanency
Stability in the home, school and community
Wellbeing, etc.
7.Is there fidelity to the Core Practice Model?
8.Are the services improving outcomes in a timely manner(service effectiveness)?
9.Are the services cost effective?
Semi-Annual Progress Reports
California Child and Family Services Review(C-CFSR)
External Quality Review Organization (EQRO)
Performance and Outcomes System (POS)
DHCS and CDSS Data Matches and Reporting
Counties report every 6 months –October and April regarding:
◦Identification of children and youthwho meet subclass criteria
◦ICC and IHBS service utilization
◦Projections for service delivery
◦Successes and barriers in localimplementation efforts
◦Implementation of the CPM
Evaluation and monitoring of long termimplementation of services and fidelity tothe CPM through the C-CFSR
◦Stakeholder process
◦Targeted State TA
◦System Improvement Plan (SIP)
◦Case Reviews
Review all 56 Mental Health Plans (MHPs) each year
Includes site visits, document review, focus groups,data analysis and reporting, Information System (IS)review, and review of Performance ImprovementProjects (PIPs)
Produce MHP reports each year
Produce a Statewide Annual Report
Distinct from Medi-Cal Oversight and ComplianceReviews
The External Quality Review Organization(EQRO) process will continue to monitor andevaluate progress at the practice and systemlevels by incorporating Katie A. focusedquestions and discussions consistent withAccountability, Communication and Oversight(ACO) and Performance Outcomes Structure(POS) recommendations once completed, intothe on-site interview process.
Purpose
For the Department of Health Care Services todevelop a performance and outcomes systemfor Medi-Cal Specialty Mental Health Servicesfor children and youth that will:
◦Improve outcomes at the individual and systemlevels
◦Inform fiscal decision making related to thepurchase of services
Provide information that improves practice atthe individual, program, and system levels inthe following domains:
◦Access
◦Engagement
◦Service Appropriateness to Need
◦Service Effectiveness
◦Linkages
◦Cost-Effectiveness
◦Satisfaction
Domain
Outcomes
Examples of indicators/measures
by age, gender, ethnicity,language, area, etc
Access
(provision of services ina timely manner)
Children served and notserved
(Penetration rate)
A & B
Relative to estimated prevalence,% of Medi-Cal beneficiaries whoreceive treatment -
(Penetration rate)
Timeliness
Wait time for evaluation,treatment
(Provider access)
Service denials
Service modifications, reductionsor terminations, are lessened
Engagement
(child and caregivers’participation andempowerment intreatment)
Children and Caregiversparticipate in services
Children and Caregivers perceiveservices as necessary,collaborative and useful
Services are maintained
Percent of clients served in a yearwith >1 mental health contact
Collaborative assessmentof environmental factors
Evaluate family functioning,relationships, community supportetc
Purpose
◦To analyze Child Welfare Services (CWS) outcomesto assess progress
◦To analyze needs, service utilization, and the use ofpsychotropic medications in the subclass
Status
◦Data Sharing Workgroup - CDSS and DHCS Staff
Supporting the development of a data sharing MOU
Identifying data elements for outcomes report(s) andmethods for data matching and displaying reports
