Report to the Operations

1

• Report to the Operations
• Sub-Committee
• November 3, 2006

2
Network Operations
3
Web Registration

• Security Access/User ID Requests
• 1,921 User Ids generated as of 10/27/06
• 14 Requests currently in process
• Winfax Non Web/Paper Registrations
• 81 providers currently using paper registration
• 34 providers transitioned from paper to web since
  9/1/06
• Security Access No Response
• 498 EDS/Medicaid Providers
• Provider Alerts sent to those 498 providers on
  9/19/06
• Response received from 213 providers
• Requesting Registration IDs or Winfaxes

4
Web Registration TotalsCompleted Web
Registrations as of 10/23/06

• Outpatient Services...17,253
• Methadone Maintenance....1,143
• Ambulatory Detoxification .58
• Family Support Team..113
• (Home Based Service)
• Psychological Testing...12

5
Web Registration Continued

• 18,579 - Registrations completed as of October
  23, 2006
• Registration timeline had been extended for an
  additional 61 days.
• Providers were given until October 31, 2006 to
  enter Web-Registrations for September 1, 2006
  dates of service and ongoing.
• The 21 day registration time limit began November
  1, 2006
• All fields for web registration are required
  effective November 1, 2006.
• Provider Alerts 10/9 10/10
• Updated User Manual will be posted to the week of
  November 6, 2006
• Updated Winfax Forms were sent to non Web enabled
  providers on 10/30/2006.

6
Provider Relations Phone Stats(September 10,
2006 - October 21, 2006)

• 1030 calls received
• Web Registration Inquiries
• General Provider Inquiries

7
Provider Data Verification Stats Aggregate since
January 2006
8
Clinical Operations
9
Timeliness of Pre-cert and CCR Process

• Analysis of current forms/process- complete
• Re-ordering/re-working of existing forms -
  complete
• Deletion of redundant information - complete
• Result more intuitive process, decrease burden
• System to be reprogrammed mid-November
• Clinician orientation and re-tooled forms on web
  site week of November 13, 2006
• Revised format implemented week of November 20,
  2006

10
Residential Care TeamTransition

• IT infrastructure close to completion, currently
  in testing (tracking system and CANs tool)
• Training with John Lyons, PhD held October 23,
  2006, 120 people trained
• Follow up training program under development
• Provider file information being updated
• Anticipated transition 12/1/06

11
Members who Access 24 hour Care by LOCOctober
2006
ADR/IPD Inpatient detox/rehabilitation GHA/GHC
Group home 1.0/2.0 IPF Inpatient Psychiatric
Facility
PRTF Psychiatric Residential Tx Facility RTC
Residential Treatment Facility
12
Authorization and Concurrent Review Update
October, 2006
13
Inpatient/PRTF Discharge Delay Status October,
2006

• 10 of children in an Inpatient settings are
  defined as Discharge Delay this represents a
  decrease from 17 last month
• 53 are awaiting placement in Residential and/or
  PRTF
• 7 are awaiting Community Services
• 20 are awaiting Group Home placement
• 14 are awaiting Placement other or unspecified
• Average length of stay in Delayed status is 47
  days
• 11 of children in Residential Treatment Centers
  are defined as Discharge Delay
• 39 are awaiting Group Home placement
• 7 are awaiting Foster Care placement
• 54 are awaiting Placement other or unspecified
  (primarily community based services training
  continues re. to code selection)

14
ED Delay Tracking October 2006
15
ED Delayed Discharge Activity

• Overview
• May 6 cases, average LOS 3.5 days
• June 5 cases, average LOS 7.2 days (1 outlier)
• July 10 cases, average LOS 2.9 days
• August 11 cases, average LOS 1.1 days
• September 26 cases, average LOS 2.0 days
• October 16 cases, average LOS 3.1 days

16
(No Transcript)
17
ICM Activity

• All delayed status members currently in
  inpatient settings are assigned (October 23, down
  from 30 in September)
• Coordinating Collateral meetings to determine
  barriers to appropriate disposition for acute
  levels of care
• Attending MSS mtgs with System Managers
• Identifying cases from daily census reports in
  MSS mtgs in order to facilitate appropriate
  treatment planning
• Contacting EDs and Area offices for updates on a
  daily basis
• Working with Systems Managers to coordinate
  meetings with each Hospital ED in Connecticut
• Monthly MCO meetings/trainings including reviews
  of co-medically managed cases

18
Customer Service/Call Center Activity
19
2006 Call Volume YTD
20
Calls answered in lt 30 seconds YTD
21
CT BHP CALL MANAGEMENTIncoming Calls Totals
September, 2006
Total 5220
22
Types of InquiriesSeptember, 2006

• 43 - Provider Referrals for Members
• 27 - Member Eligibility Verification
• 21 - Provider Related/Authorization/Enrollment/
  Billing
• 9 - General Information
  52 Member Inquiries

23
Quality Management
24
Quality Initiatives

• Data analysis, Mercer prep, QI work, integrating
  work with all departments
• Satisfaction Surveys
• Data collection began in early fall. Preliminary
  Provider Survey has been received and will now be
  analyzed. Member Survey continues with
  interviews.
• Reports complete and analyzed by January of 2007

25
Complaints
26
Total Number of Complaints Monthly 2006
27
Total Number of Complaints Quarterly 2006
28
Adult Complaints Quarterly 2006
29
Child Complaints Quarterly 2006
30
Adverse Incidents Quarterly 2006
31
Grievances

• No Grievances filed in October of 2006

32
Systems Management
33
Systems Management Update

• Three LADPs were approved by the Departments in
  September 2006
• Six LADPs were approved by the Departments in
  October 2006
• Six LADPS are due for review by the Departments
  on November 15th
• Dissemination of the approved plans have begun
  and a process has been established to disseminate
  additional copies (Glenys Rios 860-263-2164 or
  glenys.rios_at_valueoptions.com)

34
Of the approved LADPs the following themes have
been highlighted

• Increasing access to therapeutic support staff
  and other services
• Increasing access to reliable transportation
  services
• Enhancing the availability of cultural
  competence/linguistic services
• Increasing specialized services (i.e. services
  for children and youth with sexually acting out
  behavioral problems and eating disorders

35
Themes continued.

• Enhancing communication between families, schools
  and other systems/providers
• Increasing family participation in the
  collaboratives
• Increasing support for the development of
  community collaborative infrastructure

36
Community InteractionPeer/Family
Services
37
Peer Support Unit

• Peer and Family Peer Specialists worked
• with 90 CT BHP members and/or families in
• October.
• Peer and Family Peer Specialists attended
• 14 Community Outreach Meetings
• 11 Community Collaborative Meetings
• CT BHP Consumer and Family Advisory Sub-Committee
  Meeting
• 2 School Meetings

38
Peer Support Unit, continued

• 5 Home visits with members
• 1 Prospective placement visit with a family
• 6 Treatment/Discharge Planning Meetings with
  members/families
• 1 Meeting with member and nurse to collaborate on
  the co-management of a medically complicated case
  in order to be of support to member
• 1 Visit with member at the hospital
• 57 Referrals were given for various agencies and
  organizations

39
Referrals to FAVOR, its Family Organizationsand
Support Groups

• FAVOR Advocate Program 5 families
• FAVOR Familyto-Family Program 2 families
• AFCAMP 3 families
• Families United for Childrens Mental Health 7
  families
• Tri State Support Network for Families
  Raising Children with
  Bipolar-The Connecticut Group 2 families
• North Star Support Group in Ansonia 1 family
• CT BHP Peer and Family Peer Specialists
  differ from the FAVOR Family Advocates in that we
  provide primarily community education, support
  and linkages rather than traditional advocacy
  support

40
Examples of Other Referrals Given

• Bereavement Support Group at Middlesex Hospital
• The Connecticut Association for Children and
  Adults with Learning Disabilities
• Connecticut Autism Spectrum Resource Center
• Alanon
• Connecticut Employment and Training Services
• Connecticut Family Support Network
• Department of Mental Health and Addiction
  Services (DMHAS)
• Dubois CenterThompson
• Ecumenical Empowerment Group (TEEG)

• Grandparents Raising Grandchildren Support Group
• Groton Community Support Group
• Middletown Estuary Counsel of Seniors
• Office of the Child Advocate
• Office of Protection and Advocacy
• Parent Leadership Training Institute (PLTI)
• Positive Alternatives for Children and Teens,
  Inc. (PACT)
• Special Education Resource Center (SERC)
• Care Coordination with the Systems of Care
• Youth Services Bureau

41
Outreach Activities for Peer and Family Peer
Specialists

• Meeting with the Clergy Association in Middletown
• Meeting with the Middlesex Coalition for Children
• Dialogue with parents and teens at two high
  schools in Meriden
• Family Forum Presentation to Foster and Adoptive
  Parents Program in Middletown
• Booth at NAMI-CT Annual Conference
• Co-sponsor with the Eastern CT Cooperative
  Workgroup to host two workshops one for parents
  on Educational Advocacy held in Putnam and one
  for parents and professionals on The CT Family to
  Family Health Information Project held in Norwich