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CABHA Oversight

CABHA Oversight. Presented by: Sandee Resnick, DMH/DD/SAS Patrick Piggott, DMA. Purpose of CABHA Monitoring. To ensure the CABHA meets requirements for: Service Delivery Access to Care Good Standing Leadership Requirements All other Certification Requirements. No Duplication.

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CABHA Oversight

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  1. CABHA Oversight Presented by: Sandee Resnick, DMH/DD/SAS Patrick Piggott, DMA LME and CABHA Regional Kick-Off Meeting

  2. Purpose of CABHA Monitoring • To ensure the CABHA meets requirements for: • Service Delivery • Access to Care • Good Standing • Leadership Requirements • All other Certification Requirements LME and CABHA Regional Kick-Off Meeting

  3. No Duplication • CABHA Monitoring addresses the unique structural elements required for CABHA certification • National Accreditation, Endorsement, Licensure, must be in place and maintained • Service level monitoring continues via LME local monitoring, investigations, audits, licensure review, etc. LME and CABHA Regional Kick-Off Meeting

  4. Monitoring Areas • Personal Outcomes • Leadership Positions: Medical, Clinical, QM, Training Directors • Use of Community Based Treatment to Address Urgent, Emergent, Routine Needs LME and CABHA Regional Kick-Off Meeting

  5. Monitoring Areas, cont’d • Patterns of Referral • Quality Management • Integration with Physical Health Care • Core Services • Regulatory Compliance LME and CABHA Regional Kick-Off Meeting

  6. Personal Outcomes • Information from personal interviews and NCTOPPS to indicate whether people receiving services report they are: • Living in Recovery • Achieving therapeutic outcomes • Contributing members of their communities • Experiencing reduced reliance on paid services LME and CABHA Regional Kick-Off Meeting

  7. Leadership Positions • Information from data submitted and onsite review and verification to determine: • Compliance with all requirements related to each leadership position, and • Level of involvement of each position in a leadership role agency-wide. LME and CABHA Regional Kick-Off Meeting

  8. Community Based Treatment Services to Address Needs • A review of screening data and onsite verification to determine timely access to services for people with urgent, emergent and routine needs. LME and CABHA Regional Kick-Off Meeting

  9. Patterns of Referral • Personal interviews, plus onsite review of Comprehensive Clinical Assessments, ITRs and PCPs to determine: • Service decisions are based on evaluations, person-centered planning goals, recipient request • Service decisions are not limited to services offered by the CABHA LME and CABHA Regional Kick-Off Meeting

  10. Quality Management • On site review of the QM Process to determine: • Implementation of the QM Plan • Use of aggregate data and analysis • Response to the national accrediting body, related to Quality Management LME and CABHA Regional Kick-Off Meeting

  11. Core Services • Paid Claims review and onsite review to determine: • Core services continue to relate to the designated continuum • Core services staff meet qualifications, per the CABHA continuum (MH or SA). LME and CABHA Regional Kick-Off Meeting

  12. Regulatory Compliance • Data review and partial onsite verification to determine: • Major prerequisites are still current (accreditation, endorsement, licensure, etc.) • Service site locations maintained or changes reported • Compliance with state and federal laws, rules, regulation and policies LME and CABHA Regional Kick-Off Meeting

  13. Who will Monitor? • Personal Interviews conducted by DMH/DD/SAS Advocacy & Customer Service staff • Data reviews overseen by DMA and DMH/DD/SAS Quality Management Team • Onsite reviews overseen by DMA and DMH/DD/SAS Accountability Team and conducted by Accountability. DMA and local LME staff. LME and CABHA Regional Kick-Off Meeting

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