Connecticut
Medicaid Managed Care Council
Quality Assurance Subcommittee
Legislative Office Building Room 3000, Hartford CT 06106
(860) 240-0321 Info Line (860) 240-8329 FAX (860) 240-8307
www.cga.state.ct.us/ph/medicaid
QA Meeting Summary
March 22, 2001
Subcommittee Future Focus
The subcommittee chair and vice-chairs will meet to review suggestions for future focus of the subcommittee before the next meeting. Maureen Mullen, Hartford Action Plan will discuss adolescent health care access issues at the May meeting.
Children's Health Council: Childhood Injuries in HUSKY
The subcommittee had, in the past, recommended that this was an important area to assess within the HUSKY program, as `unintentional' injuries are costly yet preventable, according to Dr. Robert Zavoski at the CCMC. The CHC has begun a study of the prevalence of childhood injuries in HUSKY A. , using HUSKY encounter data as well as other State and national data sources.
The scope of the public health issue of childhood injuries was presented by CCMC in an article in Connecticut Medicine, June 1998:
· Approximately 175 deaths (21/100,000) and 4,230 hospitalizations occur annually due to childhood injury.
· Nonfatal injuries resulted in over 94,000 hospital days at a cost of nearly $ 155 million annually, a median cost of $ 4000/child.
Two thirds of injuries are `unintentional', while one-third were documented as the result of `intentional' injures (violence, assault, suicide). Preliminary review of HUSKY A encounter data of enrolled HUSKY A children (213,387) in 10/98-9/99 showed:
· 19% (40,301) of the children had injury-related care, based on records for ambulatory, emergency or hospital care.
· Approximately 10% of the HUSKY A children had emergency care or were hospitalized for injuries.
· 33. 3% of ambulatory care, 53. 3% of ED visits and 1. 6% of hospitalizations were injury-related.
The discussion of the preliminary data included data limitations related to ambulatory injury coding, inability to identify fatal injuries from the encounter data as well as distinguishing unique events from follow-up care and severity of the diagnosis.
Department of Social Services
· Dental litigation continues, the Governor's budget includes funds for a dental project.
· HUSKY psychotropic study will be released in the Spring
· KidCare legislation is being considered: tensions relate to funding, structure issues.
Qualidigm Update
Jack Hubert was introduced as the person responsible for the MCO operations audit.
· Begun phase two of the psychotropic drug study
· In process with the `Mystery Shopper' audit, which may include other than private providers.
· Data validation continues.
· HUSKY B data reporting continues.
Addendum: The subcommittee will meet in May on a date other than the third Thursday as there is a satellite asthma broadcast on May 17, afternoon. (See below page 3,4). The April 19th meeting has been cancelled due to illness and school vacations.
Asthma Work Group 3/22/01
· The MCO/health provider meeting will be on 4/10 at CHA, focusing on HUSKY asthma benefits (pharmacy and DME).
· A recent presentation at BCAC (Bridgeport) described a Los Angeles computerized asthma tracking system across system providers, including PCP, hospital, school and asthma van. The BCAC task force looked to develop an asthma tracking system in Bridgeport as a means to coordinate care among multiple providers. There was insufficient time to fully develop the grant proposal; it was recommended BCAC look at community foundation funding to assist in further development of the proposal.
· Secretary Ryan (OPM) responded to the letter originating from the Asthma Forum, noting that the budget includes funds for an expansion of the Easy Breathing program; Mr. Ryan offered to review other asthma initiatives the Work Group would recommend. The group suggested that funding smoking cessation programs in HUSKY is crucial to asthma management. Legislation has again been proposed to do this but needs to be accompanied by appropriations in order for this to be implemented. The Chair will request Dr. Geertsma to respond to the letter.
· It was requested that the Asthma survey related to school nurse reports of student asthma rates be presented at a future meeting.
· DPH will be developing an asthma resource mapping of State adult and child asthma programs, as requested by the Work Group beginning with outreach to programs at the DPH May Asthma Summit.