Mental Health Performance Measures

1. Mental Health Performance Measures Presented by: Solano County Mental Health August 10, 2009

2. To Be Covered • Type and Location of Behavioral Health Practitioners • Access • Communication and Coordination of Care • Coordination and Satisfaction Survey Results

3. Behavioral Health Practitioners EXTERNAL NETWORK PRACTITIONERS • MD 5 (4 Inpatient) • PhD/PsyD 15 • LCSW 13 • MFT 39 • TOTAL 72

4. Behavioral Health Practitioners LOCATION OF EXTERNAL PRACTITIONERS • Benicia 9 • Concord 1 • Dixon 3 • Fairfield 14 • Napa 4 • Oakland 2 • Rio Vista 1 • Vacaville 16 • Vallejo 22 • TOTAL 72

5. Behavioral Health Practitioners SCMH Provider Directory Complies with CFR • Name, location, and telephone number in beneficiary's service area by category • Language(s) used in treatment • Provider license type • Provider gender and ethnicity • Population served • Open / Closed Status

6. Geographic Distribution of Behavioral Health Providers

7. Geographic Distribution of Behavioral Health Practitioners Solano County Mental Health Clients Relative to Providers • Managed Care (External Network Clients) • Internal Network Clients • 10 mile Buffer from External Network Providers • 10 mile Buffer from Internal Network Providers

9. Geographic Distribution of Behavioral Health Practitioners STATISTICS • 100% of all Mental Health Clients are within 17.5 miles of any Mental Health Provider. • 99.5% of all Mental Health Clients are within 10 miles of any Mental Health Provider. • 99.4% of Mental Health Internal Network Clients are within 10 miles of Internal Network Providers. • 92.4% of Mental Health External Network Clients are within 10 miles of External Network Providers.

10. Appointment Access NON-LIFE THREATENING EMERGENCIES When Access Unit staff determines that a caller is in need of emergent care, the caller is warm transferred to Mobile Crisis. This procedure is in compliance with the Solano County Department of Health & Social Services Mental Health Division’s Policies and Procedures: • 100-A • AAA-2.5

11. Appointment Access URGENT CARE Callers are provided a “warm transfer” to Mobile Crisis when Access staff determines urgent assessment and intervention is required. This policy is in compliance with Solano County Mental Health Policy and Procedure 100-A.

12. Appointment Access ROUTINE CARE REFERRAL AND AUTHORIZATION FOR SERVICES MADE TO: • COUNTY OUTPATIENT CLINICS • CONTRACT AGENCIES • EXTERNAL NETWORK PROVIDERS DATA INTEGRATION PROJECT IS IN DEVELOPMENT TO LINK INFORMATION FROM MULTIPLE MENTAL HEALTH PROVIDERS. ESTIMATED COMPLETION DATE IS AUGUST 2010.

13. Telephone Access TOTAL CALLS 1,185 CALLS COMPLETED 6-15-09 TO 7-15-09 • 607 INBOUND • 578 OUTBOUND CALLS ANSWERED WITHIN 50 SECOND STANDARD • 63% WITHIN 50 SECONDS • 16% IN 51 SECONDS • 1.5% IN 52-60 SECONDS • 1.3% IN>60 SECONDS

14. Telephone Access ABANDONED CALLS 18.2% INCLUDES HANG UPS & VOICEMAIL CALLS ALL VOICE MAILS CALLS ARE RETUNED BY ACCESS STAFF WITHIN 2-3 HOURS

15. Telephone Access AFTER HOURS CALLS ACCESS LINE CALLS MADE AFTER BUSINESS HOURS, ON WEEKENDS, AND ON HOLIDAYS ARE ANSWERED LIVE BY MOBILE CRISIS. 112 CALLS FROM 6-15-09 TO 7-15-09 • 59 ANSWERED 7 A.M. - 3 P.M. • 12 ANSWERED 3 P.M. – 8 P.M. • 0 ANSWERED 8 P.M. – 11 P.M. • 41 ANSWERED 11 P.M. – 7 A.M.

16. Communication and Coordination of Care 228 PRIMARY CARE PHYSICIAN (PCP) REFERRALS COMPLETED IN FY 08-09 BEHAVIORAL HEALTH PRACTITIONERS COLLABORATE WITH PCP ABOUT PATIENT CARE THROUGH: • ON SITE CONTACT WITH PCPS AT SOLANO COUNTY FAMILY HEALTH CLINICS IN VALLEJO AND FAIRFIELD • INTAKE ASSESSMENT PROTOCOLS

17. Communication and Coordination of Care MENTAL HEALTH SERVICES ARE PROVIDED BY BEHAVIORAL HEALTH PRACTITIONERS IN NUMBEROUS WORK SETTINGS: • OUTPATIENT CLINICS • CONTRACT AGENCIES • FQHC • FAMILY HEALTH CLINICS • EXTERNAL NETWORK PROVIDER OFFICES

18. Communication and Coordination of Care BEHAVIORAL HEALTH PRACTITIONERS ARE EXPECTED TO COMMUNCATE WITH PRIMARY CARE PHYSICIANS IN ACCORDANCE WITH: • SOLANO COUNTY MENTAL HEALTH DIVISION POLICY AND PROCEDURE HIIM-3.8 • SOLANO COUNTY MENTAL HEALTH MANAGED CARE EXTERNAL NETWORK PROVIDER MANUAL • PHC POLICY/PROCEDURE MPQP1027

19. Communication and Coordination of Care COMMUNICATION IS REQUIRED • AT TREAMENT INITIATION • FOR UPDATES ABOUT SYMPTOMS AND FUNCTIOINING • CHANGES IN TREATMENT PLAN • NOTIFICATION OF HOSPITALIZATION • AT TREATMENT TERMINATION

20. Communication and Coordination of Care COMMUNICATION WITH PCP • BY TELEPHONE • BY LETTER • FAMILY HEALTH CLINIC REFERRAL FORM • BEHAVIORAL HEALTH/PRIMARY CARE PHYSICIAN COMMUNICATION FORM

21. Communication and Coordination of Care SOLANO COUNTY MENTAL HEALTH QUALTY IMPROVEMENT UNIT CONUCTS ANNUAL CHART REWIEWS OF CLIENTS SERVED BY THE MENTAL HEALTH PLAN IN ORDER TO DETERMINE COMPLIANCE WITH COMMUNICATION AND COORDINATION OF CARE STANDARDS

22. Surveys - Coordination of Care EXTERNAL NETWORK PRACTITIONERS • 78%Strongly Agree orAgree: If I receive a request for telephone advice, I am willing to provide it. • 75% Strongly Agree or Agree: With patient consent, I provide patient specific behavioral health information to member’s PCP when the patient's condition or treatment plan changes.

23. Surveys - Coordination of Care EXTERNAL NETWORK PRACTITIONERS • 69%Strongly Agree orAgree: Rather than use a written format, I prefer to contact the PCP by telephone to routinely communicate clinical information. • 66% Strongly Agree or Agree: With patient consent, I provide patient specific behavioral health information to the member’s PCP after initial evaluation of the patient.

24. Surveys - Coordination of Care INTERNAL (SHORT-DOYLE) PRACTITIONERS • 65% Strongly Agree orAgree: I frequently receive requests from PCPs for telephone consultations about patients with behavioral health conditions. • 62 % Strongly Agree or Agree: I use the PHC Behavioral Health/Primary Physician Communication Form or a similar tool to routinely communicate information to the PCP.

25. Surveys- Member Satisfaction GENERAL SATISFACTION 83% of Adults and 74% of Older Adults Strongly Agree or Agree: I liked the services I received here. If I had other choices, I would still get services from this agency. I would recommend this agency to a friend or family member.

26. Surveys- Member Satisfaction SATISFACTION WITH ACCESS 79% of Adults and 74% of Older Adults Strongly Agree or Agree: The location of services was convenient (parking, public transportation, distance, etc.). Staff were willing to see me as often as I felt it was necessary. Staff returned my call within 24 hours. Services were available at times that were good for me. I was able to get all the services I thought I needed. I was able to see a psychiatrist when I wanted to.

27. Surveys- Member Satisfaction RIGHTS & RECOVERY/WELLNESS 81% of Adults and 77% of Older Adults Strongly Agree or Agree: Staff here believe I can grow, change, and recover. I felt comfortable asking questions about my treatment and medication. I felt free to complain. I was given information about my rights. Staff encouraged me to take responsibility for how I live my life. Staff told me what side effects to watch out for.

28. Surveys- Member Satisfaction RIGHTS & RECOVERY/WELLNESS 81% of Adults and 77% of Older Adults Strongly Agree or Agree: Staff respected my wishes about who is, and who is not, to be given information about my treatment. I, not staff, decided my treatment goals. Staff were sensitive to my cultural background (race, religion, language, etc.). Staff helped me obtain the information I needed so that I could take charge of managing my illness. I was encouraged to use consumer-run programs.

29. Surveys- Member Satisfaction OUTCOMES OF SERVICES 72% of Adults and 75% of Older Adults Strongly Agree or Agree: As a direct result of services received, improved coping with • Daily Problems • Crisis Situations • Symptoms of Mental Disorders AND As a direct result of services received, improved • Housing Situation • Family Relationships • Social Skills • Work / School Performance

30. Surveys- Member Satisfaction OUTCOMES OF SERVICES 72% of Adults and 78% of Older Adults Strongly Agree or Agree: As a direct result of services received, • I do things that are more meaningful to me. • I am better able to take care of my needs. • I am better able to handle things when they go wrong. • I am better able to do the things I want to do.

31. Surveys- Member Satisfaction SOCIAL FUNCTIONING 74% of Adults and 64% of Older Adults Strongly Agree or Agree: As a direct result of services received, • Happy with Friendships • Participate in Enjoyable Activities with People • Feeling of Belongingness in Their Community • Have Necessary Support in a Crisis from Family or Friends

32. Surveys- Member Satisfaction SATISFACTION WITH SERVICES 82% of Youths and 88% of Parents/Guardians Strongly Agree or Agree: Overall, satisfied with services youth received. People helping youth, stuck with youth/family no matter what. Youth and parent felt youth had someone to talk to when he/she was troubled. Services received were right for youth and/or family. Youth and/or family got help wanted for youth. Youth and family got as much help as needed for youth.

33. Surveys- Member Satisfaction SATISFACTION WITH ACCESS 83% of Youths and 94% of Parents/Guardians Strongly Agree or Agree: The location of services was convenient. Services were available at times that were convenient.

34. Surveys- Member Satisfaction PARTICIPATION IN TREATMENT 72% of Youths and 94% of Parents/Guardians Strongly Agree or Agree: Youth and parent helped to choose youth's services. Youth and parent helped to choose youth's treatment goals. Youth and parent participated in youth’s treatment.

35. Surveys- Member Satisfaction CULTURAL SENSITIVITY 89% of Youths and 97% of Parents/Guardians Strongly Agree or Agree: Staff treated me with respect. Staff respected my family’s religious/spiritual beliefs. Staff spoke with me in a way that I understood. Staff were sensitive to my cultural/ethnic background.

36. Surveys- Member Satisfaction OUTCOMES OF SERVICES 75% of Youths and 68% of Parents/Guardians Strongly Agree or Agree: As a result of services received, youth better able to cope with • Daily Life • Problems AND As a result of services received, youth has improved • Family Relationships • Friendships and Relationships with Others • School / Work Performance • Participation in Meaningful Activities AND As a result of services received, youth and parent satisfied with family life

37. Surveys- Member Satisfaction SOCIAL CONNECTEDNESS 76%of Youths and 94% of Parents/Guardians Strongly Agree or Agree: As a result of services received: • Youth and parent can talk to people who will listen and understand. • Youth and parent can talk to people about youth’s problems. • Youth and parent would have necessary support in a crisis from family or friends. • Youth and parent participate in enjoyable activities with people.

38. Monthly Data Submission MANAGED CARE ENCOUNTER DATA • SSN • Location Of Service • Start Date and End Date • Federal ID of Provider • Diagnosis • Procedure Code • Units of Service • Amount Paid • EOB Date

39. Monthly Data Submission SHORT-DOYLE ENCOUNTER DATA • SSN • Start Date and End Date • Diagnosis • Procedure Code • Units of Service • Amount Paid

40. QUESTIONS