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WRBHO BEST Meeting

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Connecting with outpatient treatment is a standard practice for those individuals not transferring to another facility for inpatient rehabilitation (SUD). – PowerPoint PPT presentation

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Title: WRBHO BEST Meeting


1
  • WRBHO BEST Meeting
  • Quarter Three Performance Report Presentation
  • Monroe, Wyoming, Livingston Genesee Counties
  • December 13, 2012

2
WRBHO BEST Meeting Agenda
  • I. Introductions and Key Findings
  • II. Q3 Regional Overview
  • Regional Overview of all domains
  • Role of the BHO in supporting Health Homes
  • III. Q3 Sub-Regional Review (compared to the
    region)
  • Review of key metrics tied to the Effective
    Linkages domain for the sub-region
  • Discuss the information to determine what it
    means to those in attendance (Are there
    opportunities for improvement?)
  • IV. Effective practices presentations
  • Scheduling /Linking with Physical Health
    Providers RGH, Jennifer Isaac, BSN, Care Manager
    of Inpatient Psychiatric Population
  • Intro to Consumer Centered Family Consultation
    and opportunity for technical assistance
  • IV. Identify areas of focus for improving
    sub-region BH system of care
  • VI. Next Steps
  • Would a Learning Collaborative be helpful?

3
Presenters
  • Adele Gorges, Executive Director, NYCCP
  • John Lee, WRBHO Program Director, Beacon
  • Christine Mangione, WRBHO Manager of Clinical
    Operations, Beacon
  • Elisabeth Hager, MD, Physician Advisor, Beacon

4
  • INTRODUCTION KEY FINDINGS

5
Introduction
  • Q3 Performance Report Organization
  • Domains
  • Metrics within each domain (Data Sources BHO
    data collection and OMH BHO Portal)

6
The 5 Performance Metric Domains
  • Performance Domain 1 Coordination with the BHO
  • Performance Domain 2 Person-Centered Care
    Coordination during the Inpatient Stay
  • Performance Domain 3 Linkages to After Care
    Services
  • Performance Domain 4 Continuity of Care
  • Performance Domain 5 Engagement in Care

7
Highlights of WRBHO Findings
  • Observed changes that support transformation
  • Improved provider performance within the WRBHOs
    19 county region
  • 6 out of 8 metrics within the Performance Domain
    Linkage to After Care Services, reflect
    improvement Q2 to Q3.
  • A number of OMH BHO Portal metrics reflect
    performance in WNY that exceeds the Statewide
    rates outpatient visits, readmission rates.
  • County MH Directors convening meetings to engage
    providers about the changes that need to take
    place to prepare for BH Managed Care.
  • Facility COO expressing appreciation that the
    State is monitoring data to assess the ability of
    providers to work as a system of care.
  • MH inpatient providers expressing interest in
    learning how to be more effective in linking
    patients with PH providers.
  • Facility discharge planners requesting help from
    the WRBHO in securing housing for a patient,
    recognizing impact on avoidance of readmissions.
  • Providers devoting a full day to listen to
    feedback from those with a inpatient psychiatric
    experience (The WRBHO forums)

8
  • REGIONAL PROVIDER PROFILE PERFORMANCE REPORTS

9
Performance Domain 1 Coordination with the RBHO
  • Domain includes measures helpful in ensuring
    complete and timely data report and review
    practices
  • Metrics
  • The number of Notices of Admission submitted by
    providers is consistent with established targets
  • Notices of Admission are received within 24 hours
    of admission
  • Initial Reviews are completed within 72 hours of
    admission

10
Performance Domain 1 Coordination with the WRBHO
Performance Metric 1(a) The number of Notices of Admission (NOAs) received is consistent with established targets
Data Source Data on NOAs provided through the eServices Portal / data gathered by WRBHO staff via telephone. Data on 2011 fee-for-service admissions provided by the NYS Office of Mental Health
Metric Calculation Total Admissions Noticed for Period / Total FFS Medicaid Admission Reported for Period
Inpatient Admission Type of Admissions Noticed to WRBHO Q1 of Admissions Noticed to WRBHO Q2 of Admissions Noticed to WRBHO Q3 Total of Admissions Noticed through Q3 Total Admissions through Quarter 3 2011 of Target (2011)
Mental Health Adult 816 828 849 2493
Mental Health Youth 192 164 157 513
Mental Health Total 1008 992 1006 3006 4268 70.40
Substance Use Detox Adult 128 72 64 264 987 26.70
Substance Use Inpatient Rehab Adult 383 264 267 914 2443 37.40
Substance Use Total 511 336 331 1178 3430 34.30
TOTAL 1519 1328 1337 4184 7698 54.35
11
Performance Domain 1 Coordination with the WRBHO
Performance Metric 1(b) Notices of Admission are Received within 24 Hours of Admission
Data Source Data gathered via phone by WRBHO clinician or e-portal entry
Metric Calculation of NOAs received within 24 hours of admission/Total admissions noticed in reporting period
Inpatient Admission Type Total admissions for current quarter NOAs within 24 hours for current quarter NOAs within 24 hours/admissions for current quarter Provider range for current quarter NOAs within 24 hours for previous quarter Variance Current vs. Previous Quarter
Mental Health Adult 849 829 97 78 - 100 95 2
Mental Health Youth 157 156 99 93 - 100 98 1
Substance Use Detox Adult 64 58 90 81 - 100 98 -8
Substance Use Inpatient Rehab Adult 267 253 94 87 - 100 89 5
Total 1337 1296 96 78 - 100 94 2
12
Performance Domain 1 Coordination with the WRBHO
Performance Metric 1(c) Initial Reviews are Completed within 72 Hours of Admission
Data Source Gathered via phone by WRBHO clinician
Metric Calculation Initial Reviews within 72 Hours of admission/Total admissions in reporting period
Inpatient Admission Type Total Admissions Current Quarter of Initial Reviews w/in 72 hours Current Quarter Initial Reviews w/in 72 hours / Total Admissions Current Quarter Provider Range Current quarter Initial Reviews w/in 72 hours / Total Admissions Previous Quarter Variance Current vs. Previous Quarter
Mental Health Adult 849 805 94 52 - 100 83 11
Mental Health Youth 157 146 92 77 - 100 85 7
Substance Use Detox Adult 64 55 85 53 - 96 94 -9
Substance Use Inpatient Rehab Adult 267 209 78 38 - 100 67 11
Total 1337 1215 90 38 - 100 80 10
13
Performance Domain 2 Person-Centered Care
Coordination During the Stay
  • Domain includes metrics that describes the extent
    to which effective, person-centered care
    coordination practices during the inpatient stay
    are evident.
  • Particular interest in efforts to ensure that the
    individuals needs have been identified so that
    an effective discharge plan can be developed.
  • Additional metrics will be added under this
    domain over time.
  • Metric
  • Treatment history is shared with the inpatient
    provider during the Initial Review

14
Performance Domain 2 Person-Centered Care
Coordination During the Stay
Performance Metric 2(a) Treatment History is Shared with the Inpatient Provider during the Initial Review
Data Source Data recorded in FlexCare by WRBHO Clinician
Metric Calculation Discharges w/Treatment History Shared/Total Discharges in Reporting Period
Inpatient Admission Type Total Discharges Current Quarter of Discharges w/Treatment History Shared Current Quarter of Discharges w/Treatment History Shared Current Quarter Provider Range Current Quarter of Discharges w/Treatment History Shared Previous Quarter Variance Current vs. Previous Quarter Regional Year-To-Date
Mental Health Adult 842 720 85 55 - 100 80 5 83
Mental Health Youth 152 136 89 70 - 100 80 9 86
Substance Use Detox Adult 66 54 81 80 - 100 84 -3 82
Substance Use Inpatient Rehab Adult 267 242 90 81 - 100 74 16 85
Total 1327 1152 86 55 - 100 79 7 84
15
Performance Domain 3 Linkages to After-Care
Services
  • Domain includes metrics that measures the extent
    to which steps were taken during the inpatient
    stay to establish linkages to needed outpatient
    services.
  • Metrics
  • The current or prior mental health outpatient
    provider was contacted during stay
  • An appointment for mental health outpatient
    treatment was scheduled as part of the discharge
    plan
  • The case summary was sent to the outpatient
    mental health or substance use disorder (SUD)
    outpatient Provider
  • A physical health appointment scheduled
    post-discharge if a physical health care need was
    identified during the stay
  • A SPOA application was submitted for case
    management, housing and other services
  • For youth with multi-system needs, the discharge
    plan includes referrals /linkages for the
    provision of basic needs
  • For youth with multi-system needs, the discharge
    plan documents post discharge educational needs
  • There is improvement in housing status for
    individuals who are homeless at admission

16
Performance Domain 3 Linkages to After-Care
Services
Provider Profile Summaries
  • Provide a drill down on the metrics presented
    at the regional level to look more closely at
    provider-level performance
  • Available for the Linkages to After Care Services
    domain metrics
  • Identification of higher performance providers
  • Strategies being deployed to achieve higher
    levels of performance.
  • Higher performing providers
  • Fall in the top 25 for the performance metric
  • 8 or more discharges during the quarter
  • Data collection process for Q3 was viewed as an
    accurate reflection of the providers work by the
    WRBHO Utilization Review Clinician.
  • Efforts have focused on identifying barriers to
    performance.

17
Performance Domain 3 Linkages to After-Care
Services
Regional Report
Performance Metric 3(a) The current or prior mental health outpatient provider was contacted during stay
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Discharges where Mental Health Outpatient Provider was Contacted During the Stay/Total of Discharges in Reporting Period
Inpatient Admission Type Total Discharges Current Quarter Where Outpatient Provider was Contacted During the Stay Current Quarter Where Outpatient Provider was Contacted During the Stay Current Quarter Provider Range Current Quarter Where Outpatient Provider was Contacted During the Stay Previous Quarter Variance
Mental Health Adult 842 662 78 49 - 100 64 14
Mental Health Youth 152 140 92 71 - 100 84 8
Total 994 802 81 49 - 100 68 13
18
Performance Domain 3 Linkages to After-Care
Services
Provider Profile Summary
Performance Metric 3(a) The current or prior mental health outpatient provider was contacted during stay
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Discharges where Mental Health Outpatient Provider was Contacted During the Stay/Total of Discharges in Reporting Period
Inpatient Admission Type Adult Mental Health Youth Mental Health
Provider Average 78 92
Provider range 49 - 100 71 - 100
Higher Performing Providers D D
Higher Performing Providers L L
Higher Performing Providers P P
19
Performance Domain 3 Linkages to After-Care
Services
Performance Metric 3(a) The current or prior mental health outpatient provider was contacted during stay
  • Best Practices
  • Gathers collateral information from outpatient
    provider and is linked closely with other
    outpatient agencies.
  • Attempts to keep MH clients within their system
    of care, which appears to help with continuity of
    care.
  • Is protocol that the Discharge Planner notifies
    outpatient provider of individuals admitted (once
    identified) and shares appropriate collateral
    information.
  • Has a no wrong door philosophy and offers
    co-existing treatment with mental and physical
    health providers in close proximity of each
    other. Encourages effective communication.

20
Performance Domain 3 Linkages to After-Care
Services
Performance Metric 3(a) The current or prior mental health outpatient provider was contacted during stay
  • Barriers
  • Gaps in communication between UR clinicians and
    discharge planners.
  • The practice is not built in to standard facility
    procedures.
  • The treatment team does not reach out to current
    or active providers to collaborate and work
    together towards the recovery of patients.

21
Performance Domain 3 Linkages to After-Care
Services
Performance Metric 3(a) The current or prior mental health outpatient provider was contacted during stay
  • WRBHO Actions
  • Clarified meaning of the indicator during
    one-on-one provider meetings through issuing a
    new review template and holding provider calls.
  • WRBHO System of Care Transition Coordinators
    role redefined to include contacting outpatient
    providers when an active client has been admitted
    and encouraging follow-up. This outreach
    continues to encourage contact between inpatient
    and outpatient providers.
  • Focused on the importance of the transition to
    outpatient treatment during the February and June
    BEST Meetings.
  • Effective linkage to after care services was the
    theme during the September 27 BEST Meeting.

22
Performance Domain 3 Linkages to After-Care
Services
VIGNETTE Linking with Past Supports to Avoid Future Readmissions
23
Performance Domain 3 Linkages to After-Care
Services
Regional Report
Performance Metric 3(b) An appointment for mental health outpatient treatment was scheduled as part of the discharge plan
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Discharges w/Appointments Scheduled for a Mental Health Outpatient Provider/ Total Mental Health Discharges in Reporting Period
Inpatient Admission Type Total Mental Health Discharges Current Quarter An Appointment for MH Treatment was Part of the Discharge Plan Current Quarter () An Appointment for MH Treatment was Part of the Discharge Plan Current Quarter () Provider Range Current Quarter An Appointment for MH Treatment was Part of the Discharge Plan Previous Quarter Variance Current vs. Previous Quarter
Mental Health Adult 842 641 76 0 - 100 81 -5
Mental Health Youth 152 108 71 0 - 100 70 1
Total 994 749 75 0 - 100 79 -4
24
Performance Domain 3 Linkages to After-Care
Services
Provider Profile Summary
Performance Metric 3(b) An appointment for mental health outpatient treatment was made as part of the discharge plan
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Discharges w/Appointments Scheduled for a Mental Health Outpatient Provider/ Total Mental Health Discharges in Reporting Period
Inpatient Admission Type Adult Mental Health Youth Mental Health
Provider Average 76 71
Provider range 0 - 100 0 - 100
Higher Performing Providers AF AF
Higher Performing Providers D D
25
Performance Domain 3 Linkages to After-Care
Services
Performance Metric 3(b) An appointment for mental health outpatient treatment was made as part of the discharge plan
  • Best Practices
  • Strong ties to the systems array of outpatient
    services facilitate effective communication and
    efficient scheduling.
  • Follow a person-centered, thorough and
    comprehensive discharge planning process.
  • Connecting with outpatient treatment is a
    standard practice for those individuals not
    transferring to another facility for inpatient
    rehabilitation (SUD).
  • Standard operating practice to ensure linkage
    with a community- based provider prior to
    discharge.
  • Intake coordinator assigned to client and follows
    him or her from inpatient to discharge.
  • Outreach is performed if the aftercare
    appointment is missed.

26
Performance Domain 3 Linkages to After-Care
Services
Performance Metric 3(b) An appointment for mental health outpatient treatment was made as part of the discharge plan
  • Barriers
  • In instances where the individuals do not have an
    outpatient provider at the time of admission,
    this process is more difficult to accomplish
    during the inpatient stay.
  • Lack of outpatient capacity is a barrier in some
    areas.
  •  

27
Performance Domain 3 Linkages to After-Care
Services
Performance Metric 3(b) An appointment for mental health outpatient treatment was scheduled as part of the discharge plan
  • WRBHO Actions
  • During September 27 BEST Meeting, providers shown
    to be successful in scheduling outpatient
    appointments spoke about their practices.
  • December BEST meeting will focus on sharing
    practices in place at providers having success
    with individuals leaving inpatient care with a
    outpatient mental health appointment scheduled.
  • WRBHO staff will follow-up directly with
    providers with lower performance in this area to
    further define barriers and identify solutions.

28
Performance Domain 3 Linkages to After-Care
Services
Regional Report
Performance Metric 3 (c) The case summary was sent to the outpatient mental health or substance use disorder (SUD) outpatient Provider
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Discharges where Case Summary was Sent to Outpatient Provider / Total of Discharges During Period
Inpatient Admission Type Total Discharges Current Quarter Case Summary was Sent to the Outpatient Provider Current Quarter () Case Summary was Sent to the Outpatient Provider Current Quarter () Provider Range Current Quarter Case Summary was Sent to the Outpatient Provider Previous Quarter () Variance Current vs. Previous Quarter
Mental Health Adult 842 555 65 0 - 100 65 0
Mental Health Youth 152 92 60 40 - 100 52 8
Substance Use Detox Adult 66 28 42 22 - 61 44 -2
Substance Use Inpatient Rehab Adult 267 116 43 9 - 83 35 8
Total 1327 791 59 0 - 100 56 3
29
Performance Domain 3 Linkages to After-Care
Services
Provider Profile Summary
Performance Metric 3 (c) The case summary was sent to the outpatient mental health or substance use disorder (SUD) outpatient Provider
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Discharges where Case Summary was Sent to Outpatient Provider / Total of Discharges During Period
Inpatient Admission Type Adult Mental Health Youth Mental Health Adult Substance Use Detox Adult Substance Use Inpatient Rehab
Provider Average 65 60 42 43
Provider range 0 - 100 40 - 100 22 - 61 9 - 83
Higher Performing Providers A A AC AC
Higher Performing Providers R R C C
Higher Performing Providers Q Q K K
Higher Performing Providers X X O O
Higher Performing Providers V V
30
Performance Domain 3 Linkages to After-Care
Services
Performance Metric 3 (c) The case summary was sent to the outpatient mental health or substance use disorder (SUD) outpatient Provider
  • Best Practices
  • Standardized practice has been implemented to
    submit the discharge summary so the outpatient
    provider is aware of the discharge diagnosis,
    GAF, and medications/instructions.
  • It is a standard operating practice that when a
    patient signs a release, case summaries are sent
    to the outpatient provider. If patient initially
    declines, staff will discuss with the patient the
    need to send the summary for good continuity of
    care.
  • Provider has effective linkages to outpatient
    programs in their organizations system of care.

31
Performance Domain 3 Linkages to After-Care
Services
Performance Metric 3 (c) The case summary was sent to the outpatient mental health or substance use disorder (SUD) outpatient Provider
  • WRBHO Actions
  • Confusion existed as to what constituted a case
    summary. WRBHO clarified definition Discharge
    instructions which include dates of admission,
    discharge diagnosis, and medication list.
  • Definition shared with providers and the WRBHO UR
    Clinicians are using this definition in their
    reviews.
  • We anticipate that we will continue to see
    improvement on this important dimension.

32
Performance Domain 3 Linkages to After-Care
Services
Regional Report
Performance Metric 3 (d) A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay
Data Source Data gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool FAX'd to the WRBHO
Metric Calculation Discharges w/physical health appointment scheduled with an outpatient provider/discharges w/physical health need identified during inpatient stay for reporting period
Inpatient Admission Type Total Discharges w/Physical Health Needs Identified Current Quarter w/Physical Health Appointment Scheduled w/ Outpatient Provider for those w/ Needs Identified Current Quarter w/ Physical Health Appointment Scheduled w/ Outpatient Provider for those w/ Needs Identified Current Quarter Provider Range Current Quarter w/ Physical Health Appointment Scheduled w/ Outpatient Provider for those w/ Needs Identified Prior Quarter Variance Current vs. Previous Quarter
Mental Health Adult 279 110 39 0 - 100 21 18
Mental Health Youth 12 6 50 0 - 100 25 25
Substance Use Detox Adult 25 5 35 0 - 100 8 27
Substance Use Inpatient Rehab Adult 49 27 55 0 - 100 14 41
Total 365 148 40 0 - 100 19 21
33
Performance Domain 3 Linkages to After-Care
Services
Provider Profile Summary
Performance Metric 3 (d) A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay
Data Source Data gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool FAX d to the WRBHO
Metric Calculation Discharges w/physical health appointment scheduled with an outpatient provider/discharges w/physical health need identified during inpatient stay for reporting period
Inpatient Admission Type Adult Mental Health Youth Mental Health Adult Substance Use Detox Adult Substance Use Inpatient Rehab
Provider Average 39 50 35 55
Provider range 0 100 0 - 100 0 - 100 0 - 100
Higher Performing Providers J J AA AA
Higher Performing Providers N N AC AC
Higher Performing Providers S S
Higher Performing Providers Z Z
34
Performance Domain 3 Linkages to After-Care
Services
Performance Metric 3 (d) A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay
  • Best Practices
  • Facility goal is to ensure that all patients are
    well connected to all areas of health care - both
    mental and physical.
  • Provider has a protocol requiring the case
    manager to link the patient with a Primary Care
    provider if the patient is admitted without one.
    The provider has developed relationships with two
    PCP practices to help expedite creating this very
    important link.
  • Provider strives to connect clients to previous
    primary care providers, if none have been
    established, they refer clients to the county
    system. The County provides a list of accepting
    physicians.

35
Performance Domain 3 Linkages to After-Care
Services
Performance Metric 3 (d) A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay
  • Barriers
  • The responsibility is placed on the individual to
    follow up with their primary care physician after
    discharge.
  • Some facilities have procedures that focus on SUD
    and mental health outpatient appointments only
    (not physical health).
  • Many individuals admitted do not have a primary
    care provider and inpatient staff says that it is
    too hard to link the individuals with a PCP
    during the inpatient stay.

36
Performance Domain 3 Linkages to After-Care
Services
Performance Metric 3 (d) A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay
  • WRBHO Actions
  • Developed a template for inpatient providers that
    details the rationale and offers a definition of
    this (and other) metric(s). Template reviewed
    with inpatient providers via webinar.
  • WRBHO Utilization Review Clinicians engaged in a
    thorough review of all questions contained in the
    review cycle to be better prepared to extract
    more accurate information from the providers
    during these reviews.
  • WRBHO will continue to work to identify effective
    practices for integrating physical health
    engagement into the behavioral health admissions
    through surveying providers for effective
    practices and sharing strategies via BEST
    Meetings and other provider forums.

37
Performance Domain 3 Linkages to After-Care
Services
Regional Report
Performance Metric 3(e) A SPOA Application was Submitted During the Inpatient Stay
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool Faxed to the WRBHO
Metric Calculation of SPOA Applications Submitted/ of Discharges in Reporting Period
Inpatient Admission Type Total Discharges Current Quarter of Discharges w/SPOA Application Submitted Current Quarter of Discharges w/SPOA Application Submitted Current Quarter Provider range for current quarter of Discharges w/SPOA Application Submitted Previous Quarter Variance Current vs. Previous Quarter
Mental Health Adult 842 104 12 0 - 66 9 3
Mental Health Youth 152 30 19 0 - 100 19 0
Substance Use Detox Adult 66 1 4 0 - 33 2 2
Substance Use Inpatient Rehab Adult 267 5 1 0 - 9 1 0
Total 1327 140 10 0 - 100 8 2
38
Performance Domain 3 Linkages to After-Care
Services
Provider Profile Summary
Performance Metric 3(e) A SPOA Application was Submitted during the Inpatient Stay
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool Faxed to the WRBHO
Metric Calculation of SPOA Applications Submitted/ of Discharges in Reporting Period
Inpatient Admission Type Adult Mental Health Youth Mental Health Adult Substance Use Detox Adult Substance Use Inpatient Rehab
Provider Average 12 19 4 1
Provider range 0 - 66 0 - 100 0- 33 0 - 9
Higher Performing Providers Q Q F F
Higher Performing Providers S S
39
Performance Domain 3 Linkages to After-Care
Services
Provider Profile Summary
Performance Metric 3(e) A SPOA Application was Submitted during the Inpatient Stay
  • Best Practices
  • Overall, SPOA referrals are made for 12 of
    adults discharged from inpatient care and 19 of
    youth. However, the range varies considerably,
    with several providers reporting much higher
    referral rates. Based on interactions with
    providers, we have identified a few practices
    that appear to be proving successful
  • SPOA consultant from the county is placed on
    each unit to help identify and assist discharge
    planners with application process.
  • Provider uses a team approach in working with the
    patient. That is, the discharge planner, the
    social worker/therapist and the MD/NPP all meet
    together with the patient to assist in
    determining needs for a successful transition.

40
Performance Domain 3 Linkages to After-Care
Services
Provider Profile Summary
Performance Metric 3(e) A SPOA Application was Submitted during the Inpatient Stay
  • Barriers
  • Lack of SPOA services (care management) to
    support the needs of those with SU diagnosis. 
  • SPOA review processes occur on a monthly basis
    only in some counties. 
  • Inpatient facilities will start process if needed
    but rely on outpatient services to finish the
    referral.
  • WRBHO Actions
  • The WRBHO has begun to work with county directors
    to assess the interest in developing greater
    consistency in SPOA processes.
  • WRBHO UR Clinicians have been oriented to county
    specific SPOA processes so that they are in a
    better position to support the providers needs
    in each county.
  • WRBHO UR Clinicians have been encouraged to
    support specific SPOA requests by helping with
    the application or even attending SPOA meetings
    to represent the needs of the individual and the
    provider.

41
Performance Domain 3 Linkages to After-Care
Services
Regional Report
Performance Metric 3(f) For youth with multi-systems needs, the discharge plan includes referrals / linkages for basic needs
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Discharges with Indication that Basic Needs Were Addressed/ of Discharges w/Multi-System Needs Identified for Reporting period
Inpatient Admission Type of Youth w/Multi-Systems Needs Identified Current Quarter of Youth w/Indication that Basic Needs were Addressed Current Quarter of Youth w/Indication that Basic Needs were Addressed Current Quarter Provider Range Current Quarter of Youth w/Indication that Basic Needs were Addressed Previous Quarter Variance Current vs. Previous Quarter
Mental Health Youth 95 94 98 87 - 100 98 0
42
Performance Domain 3 Linkages to After-Care
Services
Provider Profile Summary
Performance Metric 3(f) For youth with multi-systems needs, the discharge plan includes referrals / linkages for basic needs
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Discharges with Indication that Basic Needs Were Addressed/ of Discharges w/Multi-System Needs Identified for Reporting period
Inpatient Admission Type Youth Mental Health
Provider Average 98
Provider range 87 - 100
Higher Performing Providers A
Higher Performing Providers U
43
Performance Domain 3 Linkages to After-Care
Services
Provider Profile Summary
Performance Metric 3(f) For youth with multi-systems needs, the discharge plan includes referrals / linkages for basic needs
  • Best Practices
  • Discharge planning is comprehensive and involved
    all outside agencies.
  • Weekly team meetings are held for the
    interdisciplinary team and UR team.
  • On-site team member meetings.
  • Provider gathers collateral information from
    outpatient providers and is very knowledgeable
    about resources that are available in the
    community.

44
Performance Domain 3 Linkages to After-Care
Services
Regional Report
Performance Metric 3 (g) For youth with multi-systems needs, the discharge plan documents post-discharge educational needs
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Discharges with Indication that Educational Needs Were Addressed/ of Discharges w/Multi-System Needs Identified for Reporting period
Inpatient Admission Type of Youth w/Multi-Systems Needs Identified Current Quarter of Youth w/Indication that Educational Needs were Addressed Current Quarter of Youth w/Indication that Educational Needs were Addressed Current Quarter Provider Range Current Quarter of Youth w/Indication that Educational Needs were Addressed Previous Quarter Variance Current vs. Previous Quarter
Mental Health Youth 95 84 88 0 - 100 93 -5
45
Performance Domain 3 Linkages to After-Care
Services
Provider Profile Summary
Performance Metric 3 (g) For youth with multi-systems needs, the discharge plan documents post-discharge educational needs
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Discharges with Indication that Educational Needs Were Addressed/ of Discharges w/Multi-System Needs Identified for Reporting period
Inpatient Admission Type Youth Mental Health
Provider Average 88
Provider range 0 - 100
Higher Performing Providers A
Higher Performing Providers Z
46
Performance Domain 3 Linkages to After-Care
Services
Provider Profile Summary
Performance Metric 3 (g) For youth with multi-systems needs, the discharge plan documents post-discharge educational needs
Best Practices Supporting the multi-system
needs of children requires very comprehensive
planning, involving a number of outside agencies
in regular interdisciplinary team meetings.
Higher performing providers have made school
programming mandatory for children and youth.
47
Performance Domain 3 Linkages to After-Care
Services
Performance Metric 3(f) and (g) For youth with multi-systems needs, the discharge plan includes referrals / linkages for basic and educational needs
  • WRBHO Actions
  • WRBHO staff will review these measures with
    providers following the release of the Q3 data to
    ensure that data collection and reporting
    accurately reflect current practice.
  • A Clinical Grand Rounds scheduled for 2013 will
    focus on childrens services and will be
    presented by the WRBHO Child Psychiatrist, Mario
    Testani.   Dr. Testani will spend a portion of
    his presentation discussing the importance of
    addressing educational needs.

48
Performance Domain 3 Linkages to After-Care
Services
Regional Report
Performance Metric 3(h) Improvement in housing status for individuals who are homeless at admission
Data Source Gathered by WRBHO clinician during review
Metric Calculation of Discharges w/Improved Housing Status/ of Discharges that were Homeless at Admission for Reporting Period
Inpatient Admission Type Total Homeless at Admission Current Quarter Improvement in Housing Status for Individuals Homeless at Admission Current Quarter () Improvement in Housing Status for Individuals Homeless at Admission Current Quarter () Provider Range Current Quarter Improvement in Housing Status for Individuals Homeless at Admission Previous Quarter () Variance
Mental Health Adult 63 20 31 0 - 100 20 11
Mental Health Youth No Data No Data No Data No Data 100 No Data
Substance Use Detox Adult 7 1 33 0 - 50 No Data No Data
Substance Use Inpatient Rehab Adult 24 16 66 0 - 100 68 -2
Total 94 37 39 20 - 100 30 9
49
Performance Domain 3 Linkages to After-Care
Services
Performance Metric 3(h) Improvement in housing status for individuals who are homeless at admission
  • WRBHO Actions
  • As access to stable housing is critical to
    achieving recovery this measure has been an area
    of focus in our review and discussion of both
    system and provider performance.
  • WRBHO UR clinicians have been asked to encourage
    providers to work diligently to address this need
    for cases we review.
  • WRBHO staff has also worked with county SPOAs to
    support an expedited review for inpatients,
    especially those in need of housing.
  • Providers have been encouraged to begin the
    housing planning process for individuals admitted
    as homeless as soon as they are admitted.

50
Performance Domain 4 Continuity of Care
  • Domain includes metrics that look at the extent
    to which individuals are connected to outpatient
    mental health services following discharge from
    inpatient as well the timeliness of that
    connection.
  • Utilize data collected by WRBHO and data
    available through BHO Portal.
  • Metrics
  • The percentage of scheduled Mental Health clinic
    outpatient appointments attended (WRBHO
    collected)
  • The percentage of Mental Health Discharges
    followed by an outpatient visit for Mental Health
    treatment within 7 days (BHO Portal)
  • The percentage of SUD Detox discharges with lower
    level SUD services with 14 days (BHO Portal)
  • The percentage of SUD rehabilitation discharges
    with lower level SUD services within 14 days (BHO
    Portal)

51
Performance Domain 4 Continuity of Care
Performance Metric 4(a) Percentage of scheduled Mental Health clinic outpatient appointments attended
Data Source Data gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Outpatient Licensed Mental Health Clinic Appointments Attended Post-Discharge / of Outpatient Mental Health Appointments Attended / Total of Outpatient Mental Health Appointments Scheduled
Inpatient Admission Type of Outpatient Mental Health Appointments Scheduled Current Quarter of Outpatient Mental Health Appointments Attended Current Quarter of Outpatient Mental Health Appointments Attended Current Quarter Provider Range Current Quarter of Outpatient Mental Health Appointments Attended Previous Quarter Variance Current vs. Previous Quarter Regional Year-To-Date
Mental Health Adult 286 232 81 52-100 79 2 80
Mental Health Youth 37 30 81 0 - 100 85 -4 84
Total 320 262 81 52 - 100 80 1 80
52
Performance Domain 4 Continuity of Care
Performance Metric 4(a) Percentage of scheduled Mental Health clinic outpatient appointments attended
  • WRBHO Actions
  • WRBHO clinicians gather these data through
    follow-up w/identified the outpatient mental
    health providers.
  • WRBHO follow-up takes place for up to 60-days
    post discharge (or until there can be
    confirmation of either attendance or a no
    show.)
  • Complements data available from the BHO Portal by
    providing a more timely way for staff to monitor
    the rate at which individuals are attending their
    outpatient mental health appointments.
  • WRBHO focus will be on identifying barriers to
    after care attendance and strategies providers
    are finding effective in increasing attendance.

53
Performance Domain 4 Continuity of Care
Performance Metric 4 (b) Percentage of MH Discharges Followed by an Outpatient Visit for MH Treatment within 7 Days
Data Source NYS OMH BHO Portal
Metric Definition Frequency with which individuals receive outpatient mental health treatment within 7 days of discharge from a mental health inpatient hospitalization.
Inpatient Admission Type Western Region Q1 2012 Western Region Q4 2011 Variance Current vs. Previous Quarter Statewide Q1 2012 Variance Western Region vs. Statewide
Mental Health Adult 44.8 45.9 1 34.7 10.1
Mental Health Youth 44.3 48.1 -4 38.6 56
54
Performance Domain 4 Continuity of Care
Performance Metric 4 (c) Percentage of SUD Discharges Followed by a Lower Level SUD Service within 14 Days
Data Source NYS OMH BHO Portal
Metric Definition Frequency with which individuals receive a lower level, less intensive, substance use disorder service within 14 days following a discharge from an inpatient substance use treatment.
Inpatient Admission Type Western Region Q1 2012 Western Region Q4 2011 Variance Current vs. Previous Quarter Statewide Q1 2012 Variance Western Region vs. Statewide
Substance Use Detox Adult 58.1 50.5 7.5 33.1 25
Substance Use Inpatient Rehab Adult 47.7 47.7 0 39.5 8.2
55
Performance Domain 5 Engagement in Care
  • Metrics
  • of Mental Health discharges followed by 2 or
    more MH outpatient visits within 30 days (BHO
    Portal)
  • of SUD Detox or Rehabilitation services
    followed by 2 or more SUD services within 14 days
    of discharge (BHO Portal)

56
Performance Domain 5 Engagement in Care
Performance Metric 5(a) Percentage of MH Discharges Followed by Two or More MH Outpatient Visits within 30 Days
Data Source NYS OMH BHO Portal
Metric Definition Received two or more outpatient mental health visits within thirty days of discharge.
Inpatient Admission Type Western Region Q1 2012 Western Region Q4 2011 Variance Current vs. Previous Quarter Statewide Q1 2012 Variance Western Region vs. Statewide
Mental Health Adult 42.6 40.9 1.7 31.9 10.7
Mental Health Youth 48.9 49.6 -.7 43.3 5.6
57
Performance Domain 5 Engagement in Care
Performance Metric 5 (b) Percentage of SUD Detox or Rehabilitation Discharges Followed by Two or More Lower Level SUD Services within 14 Days of Discharge
Data Source NYS OMH BHO Portal
Metric Definition Frequency with which individuals discharged from inpatient detoxification or chemical dependence inpatient rehabilitation engage in 2 or more lower level substance use disorder treatment services within fourteen days of discharge.
Inpatient Admission Type Western Region Q1 2012 Western Region Q4 2011 Variance Current vs. Previous Quarter Statewide Q1 2012 Variance Western Region vs. Statewide
Substance Use Adult 32.2 32.5 -.3 21.4 10.8
58
  • WRBHO ROLE IN HEALTH HOMES

59
  • Role of the WRBHO in Supporting Health Homes
  •  
  • Notify inpatient providers when an admitted
    individual being reviewed by the WRBHO is
    enrolled in a Health Home or eligible for Health
    Home outreach
  • Ensure the provider has contact information for
    the Health Home care coordinator.
  • Contact Health Home care coordinators to review
    and assist with post-discharge follow-up as
    needed.
  • Share past treatment history as found in PSYCKES
    and FlexCare
  • Alert Health Home when Health Home member is
    admitted.
  • Support community referrals to Health Homes

60
  • SPECIAL /COMPLEX NEEDS POPULATION

61
Admissions for Individuals with Complex Needs Q3
62
Complex Needs Population
Special Study
  • Detox Clients who Leave Against Medical Advice
  • NYS has identified an area of interest and
    concern related to improving care coordination
    for individuals admitted to SUD detox who leave
    against medical advice (AMA).
  • These individuals do not complete treatment and
    often leave before discharge plans are in place,
    including coordinating the next level of care.
  • In addition to receiving incomplete care, these
    individuals are at risk for rapid readmission to
    detox.
  • Understanding the needs of these individuals as
    well as the barriers to their treatment may help
    us provide better, patient-centered care, and
    improve overall outcomes.
  • WRBHO is in a unique position to lead a process
    to better understand the characteristics of these
    individuals, system characteristics that may
    contribute to these discharges, to identify best
    practices that improve engagement / retention for
    this group.

63
Complex Needs Population
  • Detox Clients who Leave Against Medical Advice
    (contd)
  • Project will engage consumers and providers.
  • Learning Community will be established with the
    ultimate plan to pilot best practices in at least
    two sites.
  • Special emphasis is made to integrate knowledge
    and sensitivity of cultural issues that may
    impact an individuals experience of detox
    services and the decision to leave AMA.

64
Complex Needs Population
  • Detox Clients who Leave Against Medical Advice
    (contd)
  • Claims data from Q 1-3, 2012 were evaluated. An
    evaluation of detox AMA discharges for the 19
    county region shows the following
  • 16 of all detox discharges were AMA
  • 84 male 16 female
  • 50 white 32 black 18 Hispanic
  • Opioids were the drug of choice (DOC) for white
    individuals leaving AMA (39)
  • Alcohol was the DOC for black individuals
    leaving AMA (71)
  • Next steps include
  • Developing background materials,
  • Establishing the Learning Community
  • Identifying pilot sites to develop and test
    models to improve care coordination of
    individuals leaving detox AMA.

65
  • WRBHO
  • Q3 SUB-REGIONAL PERFORMANCE REVIEW Linkages to
    Aftercare
  • Services

66
Sub-Regional View - Discharges
Inpatient Admission Type County of Residence - Current Quarter County of Residence - Current Quarter County of Residence - Current Quarter County of Residence - Current Quarter Sub-Regional vs. Regional Sub-Regional vs. Regional Sub-Regional vs. Regional
Inpatient Admission Type Genesee Livingston Monroe Wyoming Sub-Regional Current Qtr Regional Current Qtr Sub-Regional vs. Regional
Mental Health Adult 13 4 138 9 164 842 19
Mental Health Youth 3 2 23 1 29 152 19
Substance Use Detox 0 0 22 0  22 66 33
Substance Use Inpatient Rehab Adult 9 2 25 6 42 267 5
TOTALS 25 8 208 16 257 1327 19
67
Sub-Regional View
Performance Metric 3 (a) The Current or Prior Mental Health Outpatient Provider was Contacted During the Stay The Current or Prior Mental Health Outpatient Provider was Contacted During the Stay The Current or Prior Mental Health Outpatient Provider was Contacted During the Stay The Current or Prior Mental Health Outpatient Provider was Contacted During the Stay The Current or Prior Mental Health Outpatient Provider was Contacted During the Stay The Current or Prior Mental Health Outpatient Provider was Contacted During the Stay The Current or Prior Mental Health Outpatient Provider was Contacted During the Stay The Current or Prior Mental Health Outpatient Provider was Contacted During the Stay The Current or Prior Mental Health Outpatient Provider was Contacted During the Stay
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Discharges where Mental Health Outpatient Provider was Contacted During the Stay/Total of Discharges in Reporting Period of Discharges where Mental Health Outpatient Provider was Contacted During the Stay/Total of Discharges in Reporting Period of Discharges where Mental Health Outpatient Provider was Contacted During the Stay/Total of Discharges in Reporting Period of Discharges where Mental Health Outpatient Provider was Contacted During the Stay/Total of Discharges in Reporting Period of Discharges where Mental Health Outpatient Provider was Contacted During the Stay/Total of Discharges in Reporting Period of Discharges where Mental Health Outpatient Provider was Contacted During the Stay/Total of Discharges in Reporting Period of Discharges where Mental Health Outpatient Provider was Contacted During the Stay/Total of Discharges in Reporting Period of Discharges where Mental Health Outpatient Provider was Contacted During the Stay/Total of Discharges in Reporting Period of Discharges where Mental Health Outpatient Provider was Contacted During the Stay/Total of Discharges in Reporting Period
               
Inpatient Admission Type By County of Residence - Current Quarter By County of Residence - Current Quarter By County of Residence - Current Quarter By County of Residence - Current Quarter Sub-Regional vs. Regional Sub-Regional vs. Regional Sub-Regional vs. Regional Sub-Regional vs. Regional Sub-Regional vs. Regional
Inpatient Admission Type Genesee Livingston Monroe Wyoming Sub-Regional Current Qtr Regional Current Qtr Regional Current Qtr Sub-Regional vs. Regional Sub-Regional vs. Regional
Mental Health Adult 84 66 81 55 79 78 78 1 1
Mental Health Youth 100 50 73 100 75 92 92 -17 -17
TOTALS 87 61 80 60 79 80 80 -1 -1
68
Sub-Regional View
Performance Metric 3 (b) An appointment for mental health outpatient treatment was made as part of the discharge plan An appointment for mental health outpatient treatment was made as part of the discharge plan An appointment for mental health outpatient treatment was made as part of the discharge plan An appointment for mental health outpatient treatment was made as part of the discharge plan An appointment for mental health outpatient treatment was made as part of the discharge plan An appointment for mental health outpatient treatment was made as part of the discharge plan An appointment for mental health outpatient treatment was made as part of the discharge plan An appointment for mental health outpatient treatment was made as part of the discharge plan An appointment for mental health outpatient treatment was made as part of the discharge plan
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Discharges w/Appointments Scheduled for a Mental Health Outpatient Provider/ Total Mental Health Discharges in Reporting Period of Discharges w/Appointments Scheduled for a Mental Health Outpatient Provider/ Total Mental Health Discharges in Reporting Period of Discharges w/Appointments Scheduled for a Mental Health Outpatient Provider/ Total Mental Health Discharges in Reporting Period of Discharges w/Appointments Scheduled for a Mental Health Outpatient Provider/ Total Mental Health Discharges in Reporting Period of Discharges w/Appointments Scheduled for a Mental Health Outpatient Provider/ Total Mental Health Discharges in Reporting Period of Discharges w/Appointments Scheduled for a Mental Health Outpatient Provider/ Total Mental Health Discharges in Reporting Period of Discharges w/Appointments Scheduled for a Mental Health Outpatient Provider/ Total Mental Health Discharges in Reporting Period of Discharges w/Appointments Scheduled for a Mental Health Outpatient Provider/ Total Mental Health Discharges in Reporting Period of Discharges w/Appointments Scheduled for a Mental Health Outpatient Provider/ Total Mental Health Discharges in Reporting Period
               
Inpatient Admission Type By County of Residence - Current Quarter By County of Residence - Current Quarter By County of Residence - Current Quarter By County of Residence - Current Quarter Sub-Regional vs. Regional Sub-Regional vs. Regional Sub-Regional vs. Regional Sub-Regional vs. Regional Sub-Regional vs. Regional
Inpatient Admission Type Genesee Livingston Monroe Wyoming Sub-Regional Current Qtr Regional Current Qtr Regional Current Qtr Sub-Regional vs. Regional Sub-Regional vs. Regional
Mental Health Adult 84 66 81 55 79 76 76 3 3
Mental Health Youth 100 50 73 100 75 53 53 22 22
TOTALS 87 61 80 60 79 72 72 7 7
69
Sub-Regional View
Performance Metric 3 (c) The case summary was sent to the outpatient mental health or substance use disorder (SUD) outpatient Provider The case summary was sent to the outpatient mental health or substance use disorder (SUD) outpatient Provider The case summary was sent to the outpatient mental health or substance use disorder (SUD) outpatient Provider The case summary was sent to the outpatient mental health or substance use disorder (SUD) outpatient Provider The case summary was sent to the outpatient mental health or substance use disorder (SUD) outpatient Provider The case summary was sent to the outpatient mental health or substance use disorder (SUD) outpatient Provider The case summary was sent to the outpatient mental health or substance use disorder (SUD) outpatient Provider The case summary was sent to the outpatient mental health or substance use disorder (SUD) outpatient Provider The case summary was sent to the outpatient mental health or substance use disorder (SUD) outpatient Provider
Data Source Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO Gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool faxed to the WRBHO
Metric Calculation of Discharges where Case Summary was Sent to Outpatient Provider / Total of Discharges During Period of Discharges where Case Summary was Sent to Outpatient Provider / Total of Discharges During Period of Discharges where Case Summary was Sent to Outpatient Provider / Total of Discharges During Period of Discharges where Case Summary was Sent to Outpatient Provider / Total of Discharges During Period of Discharges where Case Summary was Sent to Outpatient Provider / Total of Discharges During Period of Discharges where Case Summary was Sent to Outpatient Provider / Total of Discharges During Period of Discharges where Case Summary was Sent to Outpatient Provider / Total of Discharges During Period of Discharges where Case Summary was Sent to Outpatient Provider / Total of Discharges During Period of Discharges where Case Summary was Sent to Outpatient Provider / Total of Discharges During Period
               
Inpatient Admission Type By County of Residence - Current Quarter By County of Residence - Current Quarter By County of Residence - Current Quarter By County of Residence - Current Quarter Sub-Regional vs. Regional Sub-Regional vs. Regional Sub-Regional vs. Regional Sub-Regional vs. Regional Sub-Regional vs. Regional
Inpatient Admission Type Genesee Livingston Monroe Wyoming Sub-Regional Current Qtr Regional Current Qtr Regional Current Qtr Sub-Regional vs. Regional Sub-Regional vs. Regional
Mental Health Adult 76 75 65 66 66 65 65 1 1
Mental Health Youth 100 50 78 100 79 60 60 19 19
Substance Use Detox 0 0 59  0 59 43 43 16 16
Substance Use Inpatient Rehab 77 0 52 66 57 43 43 14 14
TOTALS 79 50 64 68 65 59 59 6 6
70
Sub-Regional View
Performance Metric 3 (d) A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay A physical health appointment scheduled post-discharge if a physical health care need was identified during the stay
Data Source Data gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool FAX'd to the WRBHO Data gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool FAX'd to the WRBHO Data gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool FAX'd to the WRBHO Data gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool FAX'd to the WRBHO Data gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool FAX'd to the WRBHO Data gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool FAX'd to the WRBHO Data gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool FAX'd to the WRBHO Data gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool FAX'd to the WRBHO Data gathered by WRBHO clinician during review, provided via the e-services portal, or Discharge Review tool FAX'd to the WRBHO
Metric Calculation Discharges w/physical health appointment scheduled with an outpatient provider/Discharges w/physical health need identified during inpatient stay for reporting period Discharges w/physical health appointment scheduled with an outpatient provider/Discharges w/physical health need identified during inpatient stay for reporting period Discharges w/physical health appointment scheduled with an outpatient provider/Discharges w/physical health need identified during inpatient stay for reporting period Discharges w/physical health appointment scheduled with an outpatient provider/Discharges w/physical health need identified during inpatient stay for reporting period Discharges w/physical health appointment scheduled with an outpatient provider/Discharges w/physical health need identified during inpatient stay for reporting period Discharges w/physical health appointment scheduled with an outpatient provider/Discharges w/physical health need identified during inpatient stay for reporting period Discharges w/physical health appointment scheduled with an outpatient provider/Discharges w/physical health need identified during inpatient stay for reporting period Discharges w/physical health appointment scheduled with an outpatient provider/Discharges w/physical health need identified during inpatient stay for reporting period Discharges w/physical health appointment scheduled with an outpatient provider/Discharges w/physical health need identified during inpatient stay for reporting period
               
Inpatient Admission Type By County of Residence - Current Quarter By County of Residence - Current Quarter By County of Residence - Current Quarter By County of Residence - Current Quarter Sub-Regional vs. Regional Sub-Regional vs. Regional Sub-Regional vs. Regional Sub-Regional vs. Regional Sub-Regional vs. Regional
Inpatient Admission Type Genesee Livingston Monroe Wyoming Sub-Regional Current Qtr Regional Current Qtr Regional Current Qtr Sub-Regional vs. Regional Sub-Regional vs. Regional
M
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