BH-TEDS What Are We Learning?

Transcription

1 MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES BH-TEDS What Are We Learning? P u t t i n g p e o p l e f i r s t, w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s, n o m a t t e r t h e i r s t a g e i n l i f e.

2 BH-TEDS From Many Perspectives SUD Data & Finance Administrator PIHP MH Reimbursement Officer I/DD Provider Reimbursement Officer Advocate O/P Biller Married to a Clinician

3 Working together for Improved Outcomes BH-TEDS: A measurement Tool

4 Today s Agenda BH-TEDS A Brief What & Why Record submission percentages Record completeness Problems and Solutions What are the outcome fields showing? How do we compare across the state? Nationally? MI BH-TEDS Data Trends Kudos and red flags Questions welcomed throughout the presentation.

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6 BH-TEDS allows us to measures the magnitude and direction of change over time Co-occurring MH & SUD Education

7 BH-TEDS FY17 Records by Transaction Type as of 12/01/2017 Frequency Percent Cumulative Percent A 63, % 19.82% M 83, % 45.72% U 78, % 69.92% D 47, % 84.56% E 49, % % Total 322, % Frequency Percent Cumulative Percent Admission 147, % 45.72% Update 78, % 69.92% Discharge 97, % % Total 322, % Frequency Percent Cumulative Percent MH (M, U, E) 211, % 65.54% SUD (A, D) 111, % % Total 322, %

8 FY17 BH-TEDS Calculated Completeness Rates by PIHP at 12/01/17 Target = 95% Completeness Mental Health FY17 Count Unique Client ID Substance Use Disorder FY17 Count Unique Client ID Region Name Submitter ID All BH- TEDS Encounters Missing BH-TEDS FY17 % Complete* All BH- TEDS Encounters Missing BH-TEDS FY17 % Complete* CMH Partnership of SE MI 00XT 11,848 11,373 2, % 3,728 3, % Detroit-Wayne MH Authority 00XH 54,667 67,663 24, % 18,117 11, % Lakeshore Regional Entity 00ZI 25,938 21,083 2, % 8,585 5, % Macomb 00GX 13,440 12,884 1, % 7,880 5, % Mid-State Health Network ,606 42,709 2, % 12,100 10,949 3, % NorthCare Network ,961 6, % 2,707 1, % Northern MI Regional Entity ,540 14,948 3, % 6,843 4, % Oakland ,365 19,014 2, % 6,318 2, % Region ,604 16, % 8,858 6, % Southwest MI Behavioral Health ,151 21,347 4, % 9,558 6, % 249, ,057 43, % 84,694 58,890 6, % *Percent of Unique Client IDs with a non-h002-only encounter in FY17 who also have a FY17 BH-TEDS Record (M, U, E, A, D)

9 FY16 vs. FY17 Mental Health Completion Rates by PIHP % 90.00% 95% 80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% FY16 % Complete FY17 % Complete*

10 FY16 vs. FY17 SUD Completion Rates by PIHP % 90.00% 95% 80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% SUD BH-TEDS Completeness SUD BH-TEDS Completeness

11 Challenges Meeting Completion Targets

12 How do we address/accommodate for these challenges????? 1. Addition of Full-BH-TEDS Record Exception response on the MH side. Caution - NOT a get-out-of BH-TEDS Jail free card. Never a default answer State must meet stringent response criteria set by SAMHSA Not Collected FY17

13 Addressing these challenges (cont.) 2. Delay final completion/submission of records. Records are not due for a month. Currently not measuring timeliness except for year-end. Careful of double-edged sword. Have a mechanism to go back and complete what is needed. 3. Reduce the number of records being submitted. Only required at admission start, annually, and end of episode Think EPISODES not SERVICES Crisis at 9 a.m. resolved at 11 a.m. & returns at 3??? Leave the 9 a.m. admission opened. If service continues leave BH-TEDS alone until annual review. If service doesn t continue discharge will look like the admit.

14 Addressing these challenges (cont.) 4. When you simply can t be positive of an answer, let the best answer you can give/ascertain under the circumstances be good enough.

15 Where Are Referrals Coming From? Referral Source CJ Referrals 9.8% 3.1% 1.2% 5.6% 7.9% 10.2% 4.2% 0.1% 2.1% 10.9% 3.9% 52.8% 17.8% 63.8% 6.5% Individual AOD Care Provider Other Health Care School EAP Other Community CJ Federal State Court Probation or Parole Diversionary Program DUI or DWI Municipal Court Other Legal Entity Prison Other

16 Do Individuals Served Have a PSA? Michigan - PSA 42.5% 57.5% None Not None

17 Service Settings 2.0% 0.3% 10.4% 9.9% 0.2% 6.4% 3.5% 2.6% 43.7% 20.9% 0.1% 0.1% Residential Detox Short Residential Long Residential IOP Outpatient Ambulatory Detox State Psych Hospital Community Based Residential Tx Center Other psychiatric inpatient Justice System MH Assessment Only

18 Demographic Comparisons (FY16 Data Most Current SAMHSA Summary Data Available)

19 Demographic Comparisons (FY16 Data Most Current SAMHSA Summary Data Available)

20 Demographic Comparisons (FY16 Data Most Current SAMHSA Summary Data Available)

21 Outcome Comparisons (FY16 Data Most Current SAMHSA Summary Data Available)

22 Outcome Comparisons (FY16 Data Most Current SAMHSA Summary Data Available) Dependent setting not otherwise defined

23 Outcome Comparisons (FY16 Data Most Current SAMHSA Summary Data Available)

24 FY17 Outcomes as of 12/07/ % Employment Status 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% Employed Full-Time Employed Part-Time Unemployed Not in the Labor Force Admission Update Discharge

25 FY17 Outcomes as of 12/07/ % Living Arrangement 80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% Homeless Dependent Independent Residential Care Private Residence or Foster Home Crisis Residential Institutional Setting Jail Admission Update Discharge

26 FY17 Outcomes as of 12/07/ % PSA Frequency of Use 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% No Use 1-3 Days in PastMonth 1-2 Days in Past Week 3-6 Days in past Week Daily Admission Update Discharge

27 FY17 Outcomes as of 12/07/17 Corrections Related Status % 90.00% 91.29% 80.00% 70.00% 73.25% 71.75% 60.00% 50.00% 40.00% 30.00% 20.00% 21.47% 23.58% 10.00% 4.28% 5.28% 4.43% 4.67% 0.00% No Status w/corrections Status w/corrections Not Collected Admission Update Discharge

28 I/DD Designation Guidelines: Yes = documented severe, chronic condition meeting the Michigan Mental Health Code Definition of Developmental Disability. No = evaluated for I/DD and the documentation does not support a severe, chronic condition meeting the Michigan Mental Health Code Definition of Developmental Disability. Not evaluated = not been evaluated to determine if s/he meets Michigan Mental Health Code Definition of Developmental Disability.

29 MI/SED Designation Yes = individual has an MI DSM Diagnosis exclusive of I/DD or SUD OR individual has a Serious Emotional Disturbance. Yes is utilized for the entire mild to severe spectrum. This designation does NOT have to be made as a result of the PIHP s or provider s evaluation; however, must be provided by a licensed clinician operating within his/her scope of practice (i.e. psychiatrist, LMSW, Physician Assistant, Primary Care Physician, etc.).

30 Detailed SMI/SED

31 BH-TEDS Observations - Kudos Improvement in meeting 95% submission requirement. Differing responses for MH & SUD being correctly reported 99.9% of the time. Legal Status at State Hospital Field is Delivering as Intended Greatly improved demographics for 904 report

32 BH-TEDS Observations Red Flags Volume of Not Collected Responses increasing Not SMI/SED Detail Confusion Multiple M, U, & Es on the same day Hours Worked Reporting Problems Earnings Per Hour Reporting Hours worked in last 2 weeks 0 55, , , , , , , > N/A 45,480 Not Collected 15, ,722 Earnings Per Hour , , , , > N/A 45,482 Not Collected 16, ,722

33 FY18 BH-TEDS Changes Currently in Mainstream Special Education 6 - N/A added for individuals not school age (3-17 or 0-26 for those qualifying for Special Education. Not Collected MH BH-TEDS Full Record Exception added to many fields.not a get out of BH-TEDS Jail Free Card Clarification of self-employed vs. Micro-enterprise Earning at least minimum wage? Integrated environment? Integrated SUD and MH Treatment added to Update/End record. You no longer have to D/C and re-admit if this status changes.

34 FY18 BH-TEDS Changes Integrated SUD and MH Treatment added to Update/End record. You no longer have to D/C and re-admit if this status changes. Cannot have: 2 As on the same day 2 Ms on th same day 2 Us on the same day 2 Ds on the same day 2 Es on the same day An M and U on the same day A U and E on the same day

35 New Military-related fields ****This is different than the veteran question. Individuals may answer these fields who don t qualify as veterans.*** Most Recent Military Era: WWII, Korea, Vietnam, Desert Storm, Post 9/11, Peace-time Branch Served In: Army, Army National Guard, Navy, Air Force, Air National Guard, Marines, Coast Guard Family Military Service: Immediate family = spouse, mother, father, spouse, child, sibling, half-sibling Client/family enrolled in/connected to VA/veteran resources/other support & service organizations

36 BH-TEDS Contact Information Carol Hyso, MDHHS Contract Analyst, BH-TEDS Coordinator Phil Chvojka, MDHHS Specialist, BH-TEDS SA Coordinator in the Reporting Requirements Section