BH Oversight Committee
Quality
Management and Access Work Group
Meeting
Summary: March 21, 2005
Present: Dr. Davis Gammon (Chair), M. Schaefer & T. Creel (DSS), A. Kamm & A. Pritchard (DCF), L. Pierce (VOI), M. Kasper(HN), G. Luchansky (Central CGC), L. Russo (Wheeler), P. Armbruster (YCSC), B.Sheldon (NAMICT, parent), S. Niemitz (Hartf. BH), H.Gates (Community Health Resources).
Work Group Charge – Dr. Gammon state the WG will work with DSS to develop parameters for performance targets that will track the ASO’s quality of services it provides. The Departments are just as interested in timely access as they are in the quality of care the children receive once they have access.
The Departments have a base, which would be expanded to include the ASO indicators that the QA workgroup recommends as well measures of the Departments’ accountability.
ASO Performance Targets and Standards – The ASO is responsible for a certain number of functions that they are able to have impact and can influence (e.g. Care Coordination). There are certain things that they have absolutely no influence (CMAP enrollees).
Sanctions – A process to meet basic performance of the ASO. In other words, if the ASO fails to meet minimum requirements (e.g. call timeliness), they will be required to give a predetermined dollar amount back to the Department. This ensures that the ASO will maintain quality service.
Targets – (See Performance Targets Summary 03-18-05 handout for info). These allow you to drive performance based on previous years’ indicators. You can have many Targets each worth a small amount or you can have a few worth more. If you have too many Targets, the ASO will be unable to focus efficiently and if you have too few, you may not be able to effectively drive performance. These Targets can be replaced as performance is measured and effectively changed.
ASO Monitoring Indicators – Allow you to have reliable data after the first year. Based on the performance of these monitoring indicators, we can decide if we want some of these to be Targets. Some Monitoring Indicators are critical in the first year and are not as critical in subsequent years. Because of the reliability issues of existing data, we may want to focus on Monitoring Indicators that the group members are interested in. The Monitoring Indicators in Exhibit E can be monitored by the ASO or by the Departments by query using the data that the ASO provides.
Year One Implementation Targets – (See Revised Exhibit E Reporting Matrix and Sample List of Year One Implementation Targets for more information). Year One Implementation Targets tied to the 7.5% contract withhold that allow the program to get up and running within the first year. These are not interesting Targets but they are measurable and do allow us to ensure that the system will be running correctly from the start.
Review of Exhibit E Reporting Matrix - These can be potential Targets for subsequent years. Linda Pierce noted that ED data are only as reliable as what is placed on the claim. The work group would like to collect overnight ED data, ED disposition, and Connection to Care after 2 ED visits within a time period.
CHCS - HSRI – (See Performance Measurement Project Summary and Performance Measurement Project Performance Indicator Criteria List handouts for more information). The Departments applied for a grant to help them develop a KidCare report card. Human Services Research Institute (HSRI) was chosen from an RFP and they are in the process of looking at the PI list they have compiled (either through focus groups, research, and other sources) and for current PIs to choose the 50 PIs that best fit the KidCare criteria list developed by the Departments and that can be measured appropriately and accurately.
Dr. Gammon asked Dr. Schaefer to prepare a schematic as to who assess the data stream. Dr. Schaefer noted that there had been an IQMC (Inter-department Quality Management Committee) that no longer met after the Partnership was put aside. The BH Oversight Committee and work groups (or similar Council/groups) could take the place of the IQMC. DCF and DSS both will contract with the ASO. DSS will rely on the clinical oversight of DCF and the ASO to provide the analytical process.
Heather Gates stated that she would like to see some external feedback of the data stream so that the services can be reviewed and changed in a timely manner. Changes in the HUSKY program had not taken place due in part to the lack of a quality management watchdog. Barbara Sheldon stated that she is concerned that the Departments and ASO will be reviewing and monitoring their own behavior. She would like to see this subcommittee be a part of that review and monitoring process.
Paula Armbruster would like the Departments to consider using standardized discharge reports as a source of data. Mark noted that this creates a huge data management challenge. The group members need to make sure that the data we want to capture are important, able to effectively be managed, are not duplicative, not burdensome, and measure items across the entire KidCare system.
Next Meeting: April 4, 2005, 3:30 – 5:00 at the
Meriden Rushford Center.